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Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis

查看全文 作　　者：Jesús [1]Sáez;Juan [1]Martínez;Celia [2]Trigo;José Sánchez-[3]Payá;Luis Compa[4]y;Raquel [4]Laveda;Pilar Gri[4]ó;Cristina [4]García;Miguel Pérez-[4]Mateo 高影响力作者 机构地区：[1]Section of Gastroenterology and Department of Internal Medicine Hospital General Universitario de Alicante, Alicante, Spain;[2]Service of Clinical Laboratory Hospital General Universitario de Alicante, Alicante, Spain;[3]Service of Preventive Medicine Hospital General Universitario de Alicante, Alicante, Spain;[4]Section of Gastroenterology and Department of Internal MedicineHospital General Universitario de Alicante,Alicante,Spain高影响力机构 出　　处：《World Journal of Gastroenterology》索引2005年第11卷第46期,共5页高影响力期刊 基　　金：Supported by grants from the Institute de Salud Carlos III No.C03/02,No. G03/156 摘　　要：AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis. 关 键 词：尿胰蛋白酶原-2 羧肽酶 活化肽 胰腺炎
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