良性疾病合并阻塞性黄疸患者血清CA19-9显著升高的原因分析  

ANALYSIS OF EXTRAORDINARILY ELEVATED OF SERUM CA19-9 LEVELS IN BENIGN BILIARY TRACT DISEASE WITH OBSTRUCTIVE JAUNDICE

作　　者：吴涛 熊廷刚 

机构地区：[1]湖南省张家界市人民医院肝胆外科,张家界427000

出　　处：《肝胆外科杂志》2012年第5期343-345,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨良性疾病合并阻塞性黄疸时血清CA19-9显著升高的原因。方法收集37例血清CA19-9高于400 U/ml的良性疾病合并阻塞性黄疸患者。检测患者手术前、术后2周血清CA19-9、白细胞、C反应蛋白、碱性磷酸酶、r-谷氨酰转移酶、总胆红素、谷丙转氨酶、谷草转氨酶、胆汁酸水平,进一步分析CA19-9升高与白细胞、C反应蛋白、碱性磷酸酶、r-谷氨酰转移酶、总胆红素、谷丙转氨酶、谷草转氨酶、胆汁酸之间的相关性。结果血清CA19-9升高与总胆红素、r-谷氨酰转移酶、C反应蛋白相关(r=0.66、0.65、0.65;P<0.01),与白细胞、碱性磷酸酶、谷丙转氨酶、谷草转氨酶、胆汁酸无明显相关。胆道阻塞解除术后2周血清CA19-9较术前明显降低(t=6.5;P<0.01),白细胞计数及各项生化指标基本恢复正常。结论良性疾病合并阻塞性黄疸时血清CA19-9显著升高与胆道阻塞、高胆红素血症、胆管炎症相关,应该谨慎考虑对胆胰恶性肿瘤的诊断意义。Objective To Analysis the reason of extraordinarily elevated of serum carbohydrate antigen 19-9（CA19-9） in be- nign biliary tract disease with obstructive jaundice. Methods Thirty seven patients of benign biliary tract disease with obstructive jaundice with serum CA19-9 level above 400U/ml were studied. The correlations of serum CA19-9 with white blood cell（WBC） ,c-re- active protein（ CRP ）, alkaline phosphatase （ ALP ）, r-glytamyl transferase （ GGT ）, total bilirubin （ TBIL ）, alanine aminotransferase （ALT） ,aspartate aminotransferase（AST）,bile acide（BA） were analyzed, Follow-up analyze the difference between preoperative and after two weeks of postoperative. Results Significant correlations were noted between serum CA19-9 with TBIL, GGT, CRP in patients of benign biliary tract disease with obstructive jaundice （ r = 0. 66,0. 65,065 respectively ; P 〈 0. 01 ）. No significant correlations were noted between serum CA19-9 with WBC ,ALP, ALT,AST,TBA. The results show that the postoperative levels of serum CA19-9 were lower than the preoperative ones, which have significant difference （P 〈 0.01 ）. Conclusion There was a correlation in extraordinarily elevated of serum CA19-9 in benign biliary tract disease with biliary tract obstructive, hyperbilirubinemia, cholangitis. So the malignancy of diagnostic value of serum CA19-9 should consider carefully.

关 键 词：糖链抗原19-9 良性胆道疾病 阻塞性黄疸 

分 类 号：R657.4[医药卫生—外科学]