Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/xmlui/handle/11600/62812 |
Resumo: | Objetivos: estabelecer critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda de causa biliar e não biliar e identificar testes com sensibilidade suficiente para propor a criação de um algoritmo para essa finalidade. Métodos: análise retrospectiva observacional, com delineamento transversal, de exames laboratoriais de dois grupos de pacientes com pancreatite aguda: A – causa não biliar e B – causa biliar. Foram investigados os exames: hematócrito, número de leucócitos, lactato desidrogenase (LDH), glicose, lipase, amilase, bilirrubina total, transaminase oxalacética (TGO/AST), transaminase pirúvica (TGP/ALT), gamaglutamiltransferase (GGT) e fosfatase alcalina (FA). Os dados de 701 pacientes foram submetidos a testes não paramétricos e ao Receiver Operating Characteristic (ROC). Resultados: os valores de hematócrito, número de leucócitos, LDH e glicose não apresentaram diferença significante entre os grupos (p > 0.1); já os valores de lipase, amilase, bilirrubina total, TGO, TGP, GGT e FA apresentaram diferença significante entre os grupos (p < 0.05), sendo que os testes de TGP, TGO e FA mostraram-se os mais sensíveis na determinação da causa biliar, possibilitando o estabelecimento de um ponto de corte pelo teste ROC, a partir do qual a probabilidade de acerto aumenta: TGP: 123,0 U/L (S: 69,2%; E: 81,5%), TGO: 123,5 U/L (S: 57,3%; E: 78,8%), FA: 126,5 U/L (S: 66,1%; E: 69,4%). Conclusão: foi possível estabelecer critérios baseados em testes laboratoriais, para o diagnóstico diferencial entre pancreatite aguda de origem biliar e não biliar, no entanto, os testes não mostraram sensibilidade suficiente para propor a criação de um algoritmo. |
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Azevedo, Barbra Rafaela de Melo Santos [UNIFESP]http://lattes.cnpq.br/7116422825350792http://lattes.cnpq.br/8694381071456316Fagundes, Djalma José [UNIFESP]São Paulo2022-02-14T12:55:40Z2022-02-14T12:55:40Z2021https://repositorio.unifesp.br/xmlui/handle/11600/62812Objetivos: estabelecer critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda de causa biliar e não biliar e identificar testes com sensibilidade suficiente para propor a criação de um algoritmo para essa finalidade. Métodos: análise retrospectiva observacional, com delineamento transversal, de exames laboratoriais de dois grupos de pacientes com pancreatite aguda: A – causa não biliar e B – causa biliar. Foram investigados os exames: hematócrito, número de leucócitos, lactato desidrogenase (LDH), glicose, lipase, amilase, bilirrubina total, transaminase oxalacética (TGO/AST), transaminase pirúvica (TGP/ALT), gamaglutamiltransferase (GGT) e fosfatase alcalina (FA). Os dados de 701 pacientes foram submetidos a testes não paramétricos e ao Receiver Operating Characteristic (ROC). Resultados: os valores de hematócrito, número de leucócitos, LDH e glicose não apresentaram diferença significante entre os grupos (p > 0.1); já os valores de lipase, amilase, bilirrubina total, TGO, TGP, GGT e FA apresentaram diferença significante entre os grupos (p < 0.05), sendo que os testes de TGP, TGO e FA mostraram-se os mais sensíveis na determinação da causa biliar, possibilitando o estabelecimento de um ponto de corte pelo teste ROC, a partir do qual a probabilidade de acerto aumenta: TGP: 123,0 U/L (S: 69,2%; E: 81,5%), TGO: 123,5 U/L (S: 57,3%; E: 78,8%), FA: 126,5 U/L (S: 66,1%; E: 69,4%). Conclusão: foi possível estabelecer critérios baseados em testes laboratoriais, para o diagnóstico diferencial entre pancreatite aguda de origem biliar e não biliar, no entanto, os testes não mostraram sensibilidade suficiente para propor a criação de um algoritmo.Objectives: to establish laboratory criteria for the differential diagnosis between acute pancreatitis of biliary and no-biliary causes and identify tests with sufficient sensitivity to propose the creation of an algorithm for this special one. Methods: retrospective observational analysis, with cross-sectional design, laboratory tests of two groups of patients with acute pancreatitis: A - no-biliary cause and B - biliary cause. The following tests were investigated: hematocrit, leukocyte number, lactate dehydrogenase (LDH), glucose, lipase, amylase, total bilirubin, oxaloacetic transaminase (GOT/AST), pyruvic transaminase (GPT/ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP). Data from 701 patients were discovered in nonparametric tests and the Receiver Operating Characteristic (ROC). Results: the values of hematocrit, number of leukocytes, LDH and glucose did not dissipate significant difference between groups (p > 0.1); on the other hand, the values of lipase, amylase, total bilirubin, GOT, GPT, GGT and ALP dissipated significantly between the groups (p < 0.05), with the GPT, GOT and ALP tests being the most sensitive in the determination of biliary cause, enabling the establishment of a cutoff point by the ROC test, from which a probability of correctness increases: GPT: 123.0 U/L (S: 69.2%; E: 81.5%), GOT: 123.5 U/L (S: 57.3%; E: 78.8%), ALP: 126.5 U/L (S: 66.1%; E: 69.4%). Conclusion: it was possible to establish criteria based on laboratory tests for the differential diagnosis between acute pancreatitis of biliary and no-biliary origin, however, the tests do not have sufficient sensitivity to propose the creation of an algorithm.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)55 f.porUniversidade Federal de São PauloPancreatitePancreatite agudaPancreatite biliarPancreatite não biliarDiagnóstico diferencialExames laboratoriaisCritérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliarLaboratory criteria for the differential diagnosis between biliary and no-biliary acute pancreatitisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPEscola Paulista de Medicina (EPM)Ciência Cirúrgica InterdisciplinarORIGINALTESE MESTRADO BARBRA 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dc.title.pt_BR.fl_str_mv |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
dc.title.alternative.pt_BR.fl_str_mv |
Laboratory criteria for the differential diagnosis between biliary and no-biliary acute pancreatitis |
title |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
spellingShingle |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar Azevedo, Barbra Rafaela de Melo Santos [UNIFESP] Pancreatite Pancreatite aguda Pancreatite biliar Pancreatite não biliar Diagnóstico diferencial Exames laboratoriais |
title_short |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
title_full |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
title_fullStr |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
title_full_unstemmed |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
title_sort |
Critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda biliar e não biliar |
author |
Azevedo, Barbra Rafaela de Melo Santos [UNIFESP] |
author_facet |
Azevedo, Barbra Rafaela de Melo Santos [UNIFESP] |
author_role |
author |
dc.contributor.authorLattes.pt_BR.fl_str_mv |
http://lattes.cnpq.br/7116422825350792 |
dc.contributor.advisorLattes.pt_BR.fl_str_mv |
http://lattes.cnpq.br/8694381071456316 |
dc.contributor.author.fl_str_mv |
Azevedo, Barbra Rafaela de Melo Santos [UNIFESP] |
dc.contributor.advisor1.fl_str_mv |
Fagundes, Djalma José [UNIFESP] |
contributor_str_mv |
Fagundes, Djalma José [UNIFESP] |
dc.subject.por.fl_str_mv |
Pancreatite Pancreatite aguda Pancreatite biliar Pancreatite não biliar Diagnóstico diferencial Exames laboratoriais |
topic |
Pancreatite Pancreatite aguda Pancreatite biliar Pancreatite não biliar Diagnóstico diferencial Exames laboratoriais |
description |
Objetivos: estabelecer critérios laboratoriais para o diagnóstico diferencial entre pancreatite aguda de causa biliar e não biliar e identificar testes com sensibilidade suficiente para propor a criação de um algoritmo para essa finalidade. Métodos: análise retrospectiva observacional, com delineamento transversal, de exames laboratoriais de dois grupos de pacientes com pancreatite aguda: A – causa não biliar e B – causa biliar. Foram investigados os exames: hematócrito, número de leucócitos, lactato desidrogenase (LDH), glicose, lipase, amilase, bilirrubina total, transaminase oxalacética (TGO/AST), transaminase pirúvica (TGP/ALT), gamaglutamiltransferase (GGT) e fosfatase alcalina (FA). Os dados de 701 pacientes foram submetidos a testes não paramétricos e ao Receiver Operating Characteristic (ROC). Resultados: os valores de hematócrito, número de leucócitos, LDH e glicose não apresentaram diferença significante entre os grupos (p > 0.1); já os valores de lipase, amilase, bilirrubina total, TGO, TGP, GGT e FA apresentaram diferença significante entre os grupos (p < 0.05), sendo que os testes de TGP, TGO e FA mostraram-se os mais sensíveis na determinação da causa biliar, possibilitando o estabelecimento de um ponto de corte pelo teste ROC, a partir do qual a probabilidade de acerto aumenta: TGP: 123,0 U/L (S: 69,2%; E: 81,5%), TGO: 123,5 U/L (S: 57,3%; E: 78,8%), FA: 126,5 U/L (S: 66,1%; E: 69,4%). Conclusão: foi possível estabelecer critérios baseados em testes laboratoriais, para o diagnóstico diferencial entre pancreatite aguda de origem biliar e não biliar, no entanto, os testes não mostraram sensibilidade suficiente para propor a criação de um algoritmo. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021 |
dc.date.accessioned.fl_str_mv |
2022-02-14T12:55:40Z |
dc.date.available.fl_str_mv |
2022-02-14T12:55:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/xmlui/handle/11600/62812 |
url |
https://repositorio.unifesp.br/xmlui/handle/11600/62812 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
55 f. |
dc.coverage.spatial.pt_BR.fl_str_mv |
São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
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