Ulus Travma Acil Cerrahi Derg. 2006; 12(2): 115-120

Prokalsitonin þiddetli akut pankreatitin bir belirtecidir

Nurullah Bülbüller¹, Osman Doðru¹, Refik Ayten¹, Handan Akbulut², Yavuz Selim Ýlhan¹, Ziya Çetinkaya^1
1Fýrat Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, Elazýð, Türkiye
²Fýrat Üniversitesi Týp Fakültesi Ýmmünoloji Anabilim Dalý, Elazýð, Türkiye

AMAÇ: Sistemik komplikasyonlarý ile karakterize þiddetli akut pankreatitin tedavi planlanmasýnda hastalýðýn erken tehisi ve yoðun bakým ihtiyacýnýn belirlenmesi önemlidir. Bu çalýþmada, sistemik enflamasyon belirleyicisi prokalsitoninin ödematöz ve þiddetli akut pankreatit ayýrýcý tanýsýndaki yeri tartýþýldý.
GEREÇ-YÖNTEM: Prospektif olarak akut pankreatitli hastalar ödematöz ve þiddetli form olarak iki gruba ayrýldý. Ranson ve APACHE II skorlarý ve prokalsitonin seviyeleri baþvuruda ve takipte karþýlaþtýrýldý.
BULGULAR: Akut pankreatit tanýsý alan toplam 65 hastanýn 46’sý ödematöz 19’u þiddetli form idi. Prokalsitonin 0.5 ng/dl, Ranson skoru 3 ve APACHE II skoru 8 cut-off seviyelerinde duyarlýlýk ve özgüllükleri sýrasýyla %100, %84, %89 ve %84, %63, %89 idi.
SONUÇ: Prokalsitonin, þiddetli akut pankreatitin erken tanýsý ve klinik prognozunun takibinde kullanýlabilen basit ve pratik bir belirteçtir.

Anahtar Kelimeler: APACHE II, pankreatit/kan/taný; prokalsitonin; prognoz

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Procalcitonin is a predictive marker for severe acute pancreatitis

Nurullah Bülbüller¹, Osman Doðru¹, Refik Ayten¹, Handan Akbulut², Yavuz Selim Ýlhan¹, Ziya Çetinkaya^1
1Departments Of General Surgery, Medicine Faculty Of Fýrat University, Elazýð, Turkey.
²Departments Of Immunology, Medicine Faculty Of Fýrat University, Elazýð, Turkey.

BACKGROUND: Early identification of patients who develop severe acute pancreatitis and those who can benefit from intensive care is important. We studied whether procalcitonin, a marker of systemic inflammation, is important in the differential diagnosis of patients with mild and severe acute pancreatitis. METHODS: Patients were divided into two groups (mild and severe form) prospectively. Procalcitonin levels and the Ranson's and Acute Physiology and Chronic Health Evaluation II scores were determined both at admission and during the follow-up.
RESULTS: Of the 65 patients with acute pancreatitis, 46 had mild and 19 had severe pancreatitis. Sensitivity and specificity values for patients calculated using procalcitonin level at 0.5 ng/ml, Ranson's score at 3 and APACHE II score at 8 cut-off levels, were 100%, 84% and 89%; and 84%, 63% and 89% respectively. CONCLUSION: Procalcitonin is a practical, simple parameter that can be used in order to diagnose severe acute pancreatitis earlier and to monitor the clinical prognosis of the disease.

Keywords: APACHE II, pancreatitis/blood/diagnosis, procalcitonin; prognosis

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