急性胰腺炎分型系统及预测系统进展_West China Medical Journal

Authors：

 雍凤娇 ,  夏庆

四川大学华西医院中西医结合科（成都 610041）;

Corresponding author：

夏庆, Email: xiaqing@medmail.com.cn

Keywords：

急性胰腺炎; 分型系统; 预测系统

DOI：

10.7507/1002-0179.20160049

Video：

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Abstract Full text Figures/Tables Video References Cited by

急性胰腺炎（AP）是一种胰腺外分泌的炎症性疾病，轻重症临床表现与处理迥异。自1991年以来，国内外胰腺病学专家，在逐步积累急性胰腺炎治疗经验，深入研究胰腺炎发病机制的基础上，对急性胰腺炎的定义及分类标准等做了一系列的修订以更好地指导临床。在无治疗急性胰腺炎的特效药物的情况下，所有早期的治疗策略主要是支持治疗。AP病程变化差异大，预测AP患者入院时或入院24～48 h后并发症，从而进一步及早监测与干预，如早期重症监护是非常重要的。该文就AP分型系统与预测系统新进展予以阐述与总结。

Citation： 雍凤娇, 夏庆. 急性胰腺炎分型系统及预测系统进展. West China Medical Journal, 2016, 31(1): 175-179. doi: 10.7507/1002-0179.20160049 Copy

1.	Toh SK, Phillips S, Johnson CD. A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England[J]. Gut, 2000, 46(2):239-243.
2.	Neoptolemos JP, Raraty M, Finch M, et al. Acute pancreatitis:the substantial human and financial costs[J]. Gut, 1998, 42(6):886-891.
3.	Mitchell RM, Byrne MF, Pancreatitis BJ. Lancet[J]. 2003, 361(9367):1447-1455.
4.	Bradley EL. A clinically based classification system for acute pancreatitis[J]. Ann Chir, 1993, 47(6):537-541.
5.	Banks PA, Bollen TL, Dervenis C, et al. Acute pancreatitis classification working group. Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
6.	Dellinger EP, Forsmark CE, Layer P, et al. Pancreatitis across nations clinical research and education alliance (PANCREA). determinant-based classification of acute pancreatitis severity:an international multidisciplinary consultation[J]. Ann Surg, 2012, 256(6):875-880.
7.	Wilson C, Heath DI, Imrie CW. Prediction of outcome in acute pancreatitis:a comparative study of APACHEⅡ, clinical assessment and multiple factor scoring systems[J]. Br J Surg, 1990, 77(11):1260-1264.
8.	Corfield AP, Cooper MJ, Williamson RC, et al. Prediction of severity in acute pancreatitis:prospective comparison of three prognostic indices[J]. Lancet, 1985, 2(8452):403-407.
9.	Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis[J]. Surg Gynecol Obstet, 1974, 139(1):69-81.
10.	Imrie CW, Benjamin IS, Ferguson JC, et al. A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis[J]. Br J Surg, 1978, 65(5):337-341.
11.	Osborne DH, Imrie CW, Carter DC. Biliary surgery in the same admission for gallstone-associated acute pancreatitis[J]. Br J Surg, 1981, 68(11):758-761.
12.	Blamey SL, Imrie CW, O'neill J, et al. Prognostic factors in acute pancreatitis[J]. Gut, 1984, 25(12):1340-1346.
13.	Mcmahon MJ, Playforth MJ, Pickford IR. A compaative study of methods for the prediction of severity of attacks of acute pancreatitis[J]. Br J Surg, 1980, 67(1):22-25.
14.	Wu BU, Bakker OJ, Papachristou GI, et al. Blood urea nitrogen in the early assessment of acute pancreatitis:an international validation study[J]. Arch Intern Med, 2011, 171(7):669-676.
15.	Hlatky MA, Greenland P, Arnett DK, et al. Criteria for evaluation of novel markers of cardiovascular risk:a scientific statement from the American Heart Association[J]. Circulation, 2009, 119(17): 2408-2416.
16.	Papachristou GI, Papachristou DJ, Avula H, et al. Obesity increases the severity of acute pancreatitis:performance of APACHE-O score and correlation with the inflammatory response[J]. Pancreatology, 2006, 6(4):279-285.
17.	Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis:a large population-based study[J]. Gut, 2008, 57(12):1698-1703.
18.	Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(4):966-971.
19.	Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis[J]. Am J Gastroenterol, 2010, 105(2):435-441.
20.	Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis[J]. Gastroenterology, 2012, 142(7): 1476-1482.
21.	Larvin M, Chalmers AG, Mcmahon MJ. Dynamic contrast enhanced computed tomography:a precise technique for identifying and localising pancreatic necrosis[J]. BMJ, 1990, 300(6737):1425-1428.
22.	Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis:value of CT in establishing prognosis[J]. Radiology, 1990, 174(2):331-336.
23.	Simchuk EJ, Traverso LW, Nukui Y, et al. Computed tomography severity index is a predictor of outcomes for severe pancreatitis[J]. Am J Surg, 2000, 179(5):352-355.
24.	London NJ, Neoptolemos JP, Lavelle J, et al. Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis:a prospective study[J]. Br J Surg, 1989, 76(3):268-272.
25.	Bollen TL, Singh VK, Maurer R, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis[J]. Am J Gastroenterol, 2012, 107(4):612-619.
26.	Puolakkainen P, Valtonen V, Paananen A, et al. C-reactive protein (CRP) and serum phospholipase A2 in the assessment of the severity of acute pancreatitis[J]. Gut, 1987, 28(6):764-771.
27.	Mayer JM, Raraty M, Slavin J, et al. Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis[J]. Br J Surg, 2002, 89(2):163-171.
28.	Rau B, Steinbach G, Baumgart K, et al. Serum amyloid A versus C-reactive protein in acute pancreatitis:clinical value of an alternative acute-phase reactant[J]. Crit Care Med, 2000, 28(3):736-742.
29.	Mentula P, Kylänpää ML, Kemppainen E, et al. Early prediction of organ failure by combined markers in patients with acute pancreatitis[J]. Br J Surg, 2005, 92(1):68-75.
30.	Pezzilli R, Melzi D'eril GV, Morselli-Labate AM, et al. Serum amyloid A, procalcitonin, and C-reactive protein in early assessment of severity of acute pancreatitis[J]. Dig Dis Sci, 2000, 45(6): 1072-1078.
31.	Al-Nawas B, Krammer I, Shah PM. Procalcitonin in diagnosis of severe infections[J]. Eur J Med Res, 1996, 1(7):331-333.
32.	Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(8844):515-518.
33.	Kylänpää-Bäck ML, Takala A, Kemppainen E, et al. Procalcitonin strip test in the early detection of severe acute pancreatitis[J]. Br J Surg, 2001, 88(2):222-227.
34.	Rau B, Steinbach G, Gansauge F, et al. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis[J]. Gut, 1997, 41(6):832-840.
35.	Brunkhorst FM, Eberhard OK, Brunkhorst R. Early identification of biliary pancreatitis with procalcitonin[J]. Am J Gastroenterol, 1998, 93(7):1191-1192.
36.	Neoptolemos JP, Carr-Locke DL, London NJ, et al. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones[J]. Lancet, 1988, 2(8618):979-983.
37.	Van Geenen EJ, Van Santvoort HC, Besselink MG, et al. Lack of consensus on the role of endoscopic retrograde cholangiography in acute biliary pancreatitis in published meta-analyses and guidelines:a systematic review[J]. Pancreas, 2013, 42(5):774-780.
38.	Kylänpää-Bäck ML, Takala A, Kemppainen EA, et al. Procalcitonin, soluble interleukin-2 receptor, and soluble E-selectin in predicting the severity of acute pancreatitis[J]. Crit Care Med, 2001, 29(1): 63-69.
39.	Rau BM, Kemppainen EA, Gumbs AA, et al. Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT):a prospective international multicenter study[J]. Ann Surg, 2007, 245(5):745-754.
40.	Rau B, Krüger CM, Schilling MK. Procalcitonin:improved biochemical severity stratification and postoperative monitoring in severe abdominal inflammation and sepsis[J]. Langenbecks Arch Surg, 2004, 389(2):134-144.
41.	Modrau IS, Floyd AK, Thorlacius-Ussing O. The clinical value of procalcitonin in early assessment of acute pancreatitis[J]. Am J Gastroenterol, 2005, 100(7):1593-1597.
42.	Neoptolemos JP, Kemppainen EA, Mayer JM, et al. Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide:a multicentre study[J]. Lancet, 2000, 355(9219):1955-1960.
43.	Chen CC, Wang SS, Lee FY, et al. Proinflammatory cytokines in early assessment of the prognosis of acute pancreatitis[J]. Am J Gastroenterol, 1999, 94(1):213-218.
44.	Heresbach D, Letourneur JP, Bahon I, et al. Value of early blood Th-1 cytokine determination in predicting severity of acute pancreatitis[J]. Scand J Gastroenterol, 1998, 33(5):554-560.
45.	Kaufmann P, Tilz GP, Lueger A, et al. Elevated plasma levels of soluble tumor necrosis factor receptor (sTNFRp60) reflect severity of acute pancreatitis[J]. Intensive Care Med, 1997, 23(8):841-848.
46.	Mckay CJ, Imrie CW. The continuing challenge of early mortality in acute pancreatitis[J]. Br J Surg, 2004, 91(10):1243-1244.
47.	Brivet FG, Emilie D, Galanaud P, et al. Pro- and anti-inflammatory cytokines during acute severe pancreatitis:an early and sustained response, although unpredictable of death[J]. Crit Care Med, 1999, 27(4):749-755.
48.	Mayer J, Rau B, Gansauge F, et al. Inflammatory mediators in human acute pancreatitis:clinical and pathophysiological implications[J]. Gut, 2000, 47(4):546-552.
49.	Dugernier TL, Laterre PF, Wittebole X, et al. Compartmentalization of the inflammatory response during acute pancreatitis:correlation with local and systemic complications[J]. Am J Respir Crit Care Med, 2003, 168(2):148-157.
50.	Ikei S, Ogawa M, Yamaguchi Y. Blood concentrations of polymorphonuclear leucocyte elastase and interleukin-6 are indicators for the occurrence of multiple organ failures at the early stage of acute pancreatitis[J]. J Gastroenterol Hepatol, 1998, 13(12):1274-1283.
51.	Pezzilli R, Morselli-Labate AM, Miniero R, et al. Simultaneous serum assays of lipase and interleukin-6 for early diagnosis and prognosis of acute pancreatitis[J]. Clin Chem, 1999, 45(10): 1762-1767.
52.	Wereszcynska-Siemiatkowska U, Dabrowski A, Jedynak M, et al. Oxidativestress as an early prognostic factor in acute pancreatitis:its correlation with serumphospholipase A2 and plasma polymorphonuclear elastase in different severity forms of human acute pancreatitis[J]. Pancreas, 1998, 17(2):163-168.
53.	Dominguez-Munoz C, Carballo F, Garcia MJ, et al. Clinical usefulness ofpolymorphonuclear elastase in predicting the severity of acute pancreatitis:results of a multicenter study[J]. Br J Surg, 1991, 78(10):1230-1234.
54.	Uhl W, Büchler M, Malfertheiner P, et al. PMN-elastase in comparison with CRP, antiproteases, and LDH as indicators of necrosis in human acute pancreatitis[J]. Pancreas, 1991, 6(3): 253-259.
55.	Domínguez-Muñoz JE, Villanueva A, Lariño J, et al. Accuracy of plasma levels of polymorphonuclear elastase as early prognostic marker of acute pancreatitis in routine clinical conditions[J]. Eur J Gastroenterol Hepatol, 2006, 18(1):79-83.
56.	Gross V, Schölmerich J, Leser HG, et al. Granulocyte elastase in assessment of severity of acute pancreatitis[J]. Dig Dis Sci, 1990, 35(1):97-105.
57.	Viedma JA, Pérez-Mateo M, Agulló J, et al. Inflammatory response in the early prediction of severity in human acute pancreatitis[J]. Gut, 1994, 35(6):822-827.
58.	Borgström A, Appelros S, Müller CA, et al. Role of activation peptides from pancreatic proenzymes in the diagnosis and prognosis of acute pancreatitis[J]. Surgery, 2002, 131(2):125-128.
59.	Kemppainen EA, Hedström JI, Puolakkainen PA, et al. Advances in the laboratory diagnostics of acute pancreatitis[J]. Ann Med, 1998, 30(2):169-175.
60.	Tenner S, Fernandez-Del Castillo C, Warshaw A, et al. Urinary trypsinogen activation peptide (TAP) predicts severity in patients with acute pancreatitis[J]. Int J Pancreatol, 1997, 21(2):105-110.
61.	Johnson CD, Lempinen M, Imrie CW, et al. Urinary trypsinogen activation peptide as a marker of severe acute pancreatitis[J]. Br J Surg, 2004, 91(8):1027-1033.
62.	Appelros S, Petersson U, Toh S, et al. Activation peptide of carboxypeptidase band anionic trypsinogen as early predictors of the severity of acute pancreatitis[J]. Br J Surg, 2001, 88(2):216-221.
63.	Müller CA, Appelros S, Uhl W, et al. Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases[J]. Gut, 2002, 51(2):229-235.
64.	Sáez J, Martínez J, Trigo C, et al. A comparative study of the activation peptide of carboxypeptidase B and trypsinogen as early predictors of the severity of acute pancreatitis[J]. Pancreas, 2004, 29(1):e9-14.
65.	Bollen TL. Imaging of acute pancreatitis:update of the revised Atlanta classification[J]. Radiol Clin North Am, 2012, 50(3):429-445.

1. Toh SK, Phillips S, Johnson CD. A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England[J]. Gut, 2000, 46(2):239-243.
2. Neoptolemos JP, Raraty M, Finch M, et al. Acute pancreatitis:the substantial human and financial costs[J]. Gut, 1998, 42(6):886-891.
3. Mitchell RM, Byrne MF, Pancreatitis BJ. Lancet[J]. 2003, 361(9367):1447-1455.
4. Bradley EL. A clinically based classification system for acute pancreatitis[J]. Ann Chir, 1993, 47(6):537-541.
5. Banks PA, Bollen TL, Dervenis C, et al. Acute pancreatitis classification working group. Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
6. Dellinger EP, Forsmark CE, Layer P, et al. Pancreatitis across nations clinical research and education alliance (PANCREA). determinant-based classification of acute pancreatitis severity:an international multidisciplinary consultation[J]. Ann Surg, 2012, 256(6):875-880.
7. Wilson C, Heath DI, Imrie CW. Prediction of outcome in acute pancreatitis:a comparative study of APACHEⅡ, clinical assessment and multiple factor scoring systems[J]. Br J Surg, 1990, 77(11):1260-1264.
8. Corfield AP, Cooper MJ, Williamson RC, et al. Prediction of severity in acute pancreatitis:prospective comparison of three prognostic indices[J]. Lancet, 1985, 2(8452):403-407.
9. Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis[J]. Surg Gynecol Obstet, 1974, 139(1):69-81.
10. Imrie CW, Benjamin IS, Ferguson JC, et al. A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis[J]. Br J Surg, 1978, 65(5):337-341.
11. Osborne DH, Imrie CW, Carter DC. Biliary surgery in the same admission for gallstone-associated acute pancreatitis[J]. Br J Surg, 1981, 68(11):758-761.
12. Blamey SL, Imrie CW, O'neill J, et al. Prognostic factors in acute pancreatitis[J]. Gut, 1984, 25(12):1340-1346.
13. Mcmahon MJ, Playforth MJ, Pickford IR. A compaative study of methods for the prediction of severity of attacks of acute pancreatitis[J]. Br J Surg, 1980, 67(1):22-25.
14. Wu BU, Bakker OJ, Papachristou GI, et al. Blood urea nitrogen in the early assessment of acute pancreatitis:an international validation study[J]. Arch Intern Med, 2011, 171(7):669-676.
15. Hlatky MA, Greenland P, Arnett DK, et al. Criteria for evaluation of novel markers of cardiovascular risk:a scientific statement from the American Heart Association[J]. Circulation, 2009, 119(17): 2408-2416.
16. Papachristou GI, Papachristou DJ, Avula H, et al. Obesity increases the severity of acute pancreatitis:performance of APACHE-O score and correlation with the inflammatory response[J]. Pancreatology, 2006, 6(4):279-285.
17. Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis:a large population-based study[J]. Gut, 2008, 57(12):1698-1703.
18. Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(4):966-971.
19. Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis[J]. Am J Gastroenterol, 2010, 105(2):435-441.
20. Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis[J]. Gastroenterology, 2012, 142(7): 1476-1482.
21. Larvin M, Chalmers AG, Mcmahon MJ. Dynamic contrast enhanced computed tomography:a precise technique for identifying and localising pancreatic necrosis[J]. BMJ, 1990, 300(6737):1425-1428.
22. Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis:value of CT in establishing prognosis[J]. Radiology, 1990, 174(2):331-336.
23. Simchuk EJ, Traverso LW, Nukui Y, et al. Computed tomography severity index is a predictor of outcomes for severe pancreatitis[J]. Am J Surg, 2000, 179(5):352-355.
24. London NJ, Neoptolemos JP, Lavelle J, et al. Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis:a prospective study[J]. Br J Surg, 1989, 76(3):268-272.
25. Bollen TL, Singh VK, Maurer R, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis[J]. Am J Gastroenterol, 2012, 107(4):612-619.
26. Puolakkainen P, Valtonen V, Paananen A, et al. C-reactive protein (CRP) and serum phospholipase A2 in the assessment of the severity of acute pancreatitis[J]. Gut, 1987, 28(6):764-771.
27. Mayer JM, Raraty M, Slavin J, et al. Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis[J]. Br J Surg, 2002, 89(2):163-171.
28. Rau B, Steinbach G, Baumgart K, et al. Serum amyloid A versus C-reactive protein in acute pancreatitis:clinical value of an alternative acute-phase reactant[J]. Crit Care Med, 2000, 28(3):736-742.
29. Mentula P, Kylänpää ML, Kemppainen E, et al. Early prediction of organ failure by combined markers in patients with acute pancreatitis[J]. Br J Surg, 2005, 92(1):68-75.
30. Pezzilli R, Melzi D'eril GV, Morselli-Labate AM, et al. Serum amyloid A, procalcitonin, and C-reactive protein in early assessment of severity of acute pancreatitis[J]. Dig Dis Sci, 2000, 45(6): 1072-1078.
31. Al-Nawas B, Krammer I, Shah PM. Procalcitonin in diagnosis of severe infections[J]. Eur J Med Res, 1996, 1(7):331-333.
32. Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(8844):515-518.
33. Kylänpää-Bäck ML, Takala A, Kemppainen E, et al. Procalcitonin strip test in the early detection of severe acute pancreatitis[J]. Br J Surg, 2001, 88(2):222-227.
34. Rau B, Steinbach G, Gansauge F, et al. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis[J]. Gut, 1997, 41(6):832-840.
35. Brunkhorst FM, Eberhard OK, Brunkhorst R. Early identification of biliary pancreatitis with procalcitonin[J]. Am J Gastroenterol, 1998, 93(7):1191-1192.
36. Neoptolemos JP, Carr-Locke DL, London NJ, et al. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones[J]. Lancet, 1988, 2(8618):979-983.
37. Van Geenen EJ, Van Santvoort HC, Besselink MG, et al. Lack of consensus on the role of endoscopic retrograde cholangiography in acute biliary pancreatitis in published meta-analyses and guidelines:a systematic review[J]. Pancreas, 2013, 42(5):774-780.
38. Kylänpää-Bäck ML, Takala A, Kemppainen EA, et al. Procalcitonin, soluble interleukin-2 receptor, and soluble E-selectin in predicting the severity of acute pancreatitis[J]. Crit Care Med, 2001, 29(1): 63-69.
39. Rau BM, Kemppainen EA, Gumbs AA, et al. Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT):a prospective international multicenter study[J]. Ann Surg, 2007, 245(5):745-754.
40. Rau B, Krüger CM, Schilling MK. Procalcitonin:improved biochemical severity stratification and postoperative monitoring in severe abdominal inflammation and sepsis[J]. Langenbecks Arch Surg, 2004, 389(2):134-144.
41. Modrau IS, Floyd AK, Thorlacius-Ussing O. The clinical value of procalcitonin in early assessment of acute pancreatitis[J]. Am J Gastroenterol, 2005, 100(7):1593-1597.
42. Neoptolemos JP, Kemppainen EA, Mayer JM, et al. Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide:a multicentre study[J]. Lancet, 2000, 355(9219):1955-1960.
43. Chen CC, Wang SS, Lee FY, et al. Proinflammatory cytokines in early assessment of the prognosis of acute pancreatitis[J]. Am J Gastroenterol, 1999, 94(1):213-218.
44. Heresbach D, Letourneur JP, Bahon I, et al. Value of early blood Th-1 cytokine determination in predicting severity of acute pancreatitis[J]. Scand J Gastroenterol, 1998, 33(5):554-560.
45. Kaufmann P, Tilz GP, Lueger A, et al. Elevated plasma levels of soluble tumor necrosis factor receptor (sTNFRp60) reflect severity of acute pancreatitis[J]. Intensive Care Med, 1997, 23(8):841-848.
46. Mckay CJ, Imrie CW. The continuing challenge of early mortality in acute pancreatitis[J]. Br J Surg, 2004, 91(10):1243-1244.
47. Brivet FG, Emilie D, Galanaud P, et al. Pro- and anti-inflammatory cytokines during acute severe pancreatitis:an early and sustained response, although unpredictable of death[J]. Crit Care Med, 1999, 27(4):749-755.
48. Mayer J, Rau B, Gansauge F, et al. Inflammatory mediators in human acute pancreatitis:clinical and pathophysiological implications[J]. Gut, 2000, 47(4):546-552.
49. Dugernier TL, Laterre PF, Wittebole X, et al. Compartmentalization of the inflammatory response during acute pancreatitis:correlation with local and systemic complications[J]. Am J Respir Crit Care Med, 2003, 168(2):148-157.
50. Ikei S, Ogawa M, Yamaguchi Y. Blood concentrations of polymorphonuclear leucocyte elastase and interleukin-6 are indicators for the occurrence of multiple organ failures at the early stage of acute pancreatitis[J]. J Gastroenterol Hepatol, 1998, 13(12):1274-1283.
51. Pezzilli R, Morselli-Labate AM, Miniero R, et al. Simultaneous serum assays of lipase and interleukin-6 for early diagnosis and prognosis of acute pancreatitis[J]. Clin Chem, 1999, 45(10): 1762-1767.
52. Wereszcynska-Siemiatkowska U, Dabrowski A, Jedynak M, et al. Oxidativestress as an early prognostic factor in acute pancreatitis:its correlation with serumphospholipase A2 and plasma polymorphonuclear elastase in different severity forms of human acute pancreatitis[J]. Pancreas, 1998, 17(2):163-168.
53. Dominguez-Munoz C, Carballo F, Garcia MJ, et al. Clinical usefulness ofpolymorphonuclear elastase in predicting the severity of acute pancreatitis:results of a multicenter study[J]. Br J Surg, 1991, 78(10):1230-1234.
54. Uhl W, Büchler M, Malfertheiner P, et al. PMN-elastase in comparison with CRP, antiproteases, and LDH as indicators of necrosis in human acute pancreatitis[J]. Pancreas, 1991, 6(3): 253-259.
55. Domínguez-Muñoz JE, Villanueva A, Lariño J, et al. Accuracy of plasma levels of polymorphonuclear elastase as early prognostic marker of acute pancreatitis in routine clinical conditions[J]. Eur J Gastroenterol Hepatol, 2006, 18(1):79-83.
56. Gross V, Schölmerich J, Leser HG, et al. Granulocyte elastase in assessment of severity of acute pancreatitis[J]. Dig Dis Sci, 1990, 35(1):97-105.
57. Viedma JA, Pérez-Mateo M, Agulló J, et al. Inflammatory response in the early prediction of severity in human acute pancreatitis[J]. Gut, 1994, 35(6):822-827.
58. Borgström A, Appelros S, Müller CA, et al. Role of activation peptides from pancreatic proenzymes in the diagnosis and prognosis of acute pancreatitis[J]. Surgery, 2002, 131(2):125-128.
59. Kemppainen EA, Hedström JI, Puolakkainen PA, et al. Advances in the laboratory diagnostics of acute pancreatitis[J]. Ann Med, 1998, 30(2):169-175.
60. Tenner S, Fernandez-Del Castillo C, Warshaw A, et al. Urinary trypsinogen activation peptide (TAP) predicts severity in patients with acute pancreatitis[J]. Int J Pancreatol, 1997, 21(2):105-110.
61. Johnson CD, Lempinen M, Imrie CW, et al. Urinary trypsinogen activation peptide as a marker of severe acute pancreatitis[J]. Br J Surg, 2004, 91(8):1027-1033.
62. Appelros S, Petersson U, Toh S, et al. Activation peptide of carboxypeptidase band anionic trypsinogen as early predictors of the severity of acute pancreatitis[J]. Br J Surg, 2001, 88(2):216-221.
63. Müller CA, Appelros S, Uhl W, et al. Serum levels of procarboxypeptidase B and its activation peptide in patients with acute pancreatitis and non-pancreatic diseases[J]. Gut, 2002, 51(2):229-235.
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