目的: 探讨急性胰腺炎( acute pancreatitis，AP) 病人血清生长抑素( SST) 水平、钙离子( Ca²⁺ ) 水平及
C 反应蛋白( CRP) 水平变化与AP 病情严重程度的关系以及对预后的评价。方法: 根据分级标准将249 例AP
病人分为轻症急性胰腺炎( MAP) 128 例，中度重症急性胰腺炎( MSAP) 79 例，重症急性胰腺炎( SAP) 42 例。另
选择40 例健康志愿者作为健康对照组，采用放射免疫法及全自动生化分析方法，分别检测各组的血清SST、Ca²⁺
和CRP 水平，将各组数据比较分析。结果: 发病＜48 h 来就诊的AP 病人中，MAP 组外周血SST 水平稍高于健康
对照组，但差异无显著性( P＞0．05) ; 而MSAP 组和SAP 组外周血SST 水平明显低于健康对照组，SAP 组亦明显
低于MSAP 组，均有显著性差异( P＜0．05) 。MAP 组、MSAP 组和SAP 组外周血Ca²⁺ 水平均明显低于健康对照
组，差异均有显著性( P＜0．05) 。MAP 组、MSAP 组和SAP 组CＲP 明显高于健康对照组，差异均有显著性( P＜
0．05) 。采用常规剂量SST－14 思他宁治疗三组胰腺炎后发现，( 1) 24 h 内血SST 水平均可升高，但对于MSAP 和
SAP，其升高程度仍远低于正常水平，持续常规剂量治疗72 h 后，MAP 及MSAP 血SST 水平略高于正常水平，无
显著差异( P＞0．05) ，而SAP 血SST 仍低于正常对照组，差异有显著性( P＜0．05) ; ( 2) 24 h 和72 h 血Ca^{2 +} 水平明
显提高，MAP 和MSAP 血Ca^{2 +}接近或恢复正常; 而SAP 组病人血Ca²⁺ 较治疗前有所升高，但仍明显低于正常对
照组( P＜0．05) ; ( 3) MAP 和MSAP 外周血CRP 水平均明显下降，MAP 基本恢复至正常对照组水平，而MASP 尽
管下降，但仍明显高于正常对照组( P＜0．05) 。结论: AP 外周血中SST 水平和Ca^{2 +} 及CRP 水平的变化可以反映
病情严重程度，对评估病人预后具有临床价值。

Objective: To investigate the relationship between the change of serum somatostatin
( SST) ，Calciumion( Ca²⁺ ) and C－reactive protein( CRP) levels and severity of illness in patients with
acute pancreatitis，and its value in the evaluation of prognosis．Methods: 249 acute pancreatitis patients
were divided into three groups according to the classification standard as mild acute pancreatitis( MAP)
128 cases，mediate severe acute pancreatitis( MSAP) 79 cases and severe acute pancreatitis( SAP) 42
cases，and also 40 healthy volunteers served as control group． The blood SST concentration，Ca²⁺ and
CRP levels was detected by radioimmunity and automatic biochemical analysis，and to explore the role
of them for the assessment of disease severity and prognosis．Results: Within 48 h of onset of acute pancreatitis，
serum levels of SST was slightly higher in MAP group than those in control group( P＞0．05) ，
but serum levels of SST was significantly lower in MSAP and SAP group than those in control group，
and more lower in SAP group than in MSAP ( P＜0．05) ．Blood Ca²⁺ levels was significantly lower in
MAP，MSAP and SAP group than those in control group( P＜0．05) ．Blood CRP levels was significantly
higher in MAP，MSAP and SAP group than those in control group，and more higher in SAP group than
in MAP and MSAP group( P＜0．05) ．After treatment of SST－14 somatostatin，( 1) all blood SST levels
raised within 24 h in three groups，but for MSAP and SAP， the elevated levels was still below normal
levels．After 72 h treatment， levels of SST in MAP and MSAP was slightly higher than normal blood levels(P＞0．05) ，but
levels of SST in SAP is still lower than normal， the difference was significant( P＜0．05)
．( 2) Blood Ca²⁺ levels with 24 h and 72 h was significantly increased，but in SAP group， the blood
Ca^{2 +} levels was still lower than the levels in control group( P＜0．05) ．( 3) Blood CRP levels was significantly
decreased in MAP and MSAP，but CRP levels in MASP was still higher than the control group
( P＜0．05) ．Conclusion: The levels of peripheral blood SST，Ca²⁺and CRP in acute pancreatitis can reflect
the severity of the illness and shows clinical value in evaluation of prognosis．

R657．5+1

 收稿日期: 2016－01－19; 修回日期: 2016－04－06
基金项目: 内蒙古教育厅重大项目( NJ2211114)
作者简介: 徐晓霞( 1989－) ，女，内蒙古医科大学2014 级在读硕士研究生。
通讯作者: 陈平，主任医师，医学博士，硕士研究生导师，E－mail: nmgcp@ sina．com 内蒙古医科大学附属医院消化内科，
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