急性化脓性胆管炎患者血清免疫抑制酸性蛋白水平的变化及其临床意义  

Changes of serum immunosuppressive acidic protein levels in patients with acute suppurative cholangitis and its clinical significance

作　　者：沈林强 沈彬[2] 孙芸 Lin-qiang Shen;Bin Shen;Yun Sun(Department of Emergency,Zhejiang Xin’an International Hospital,Jiaxing,Zhejiang 314050,China;Department of Hepatobiliary,Jiaxing Traditional Chinese Medicine Hospital,Jiaxing,Zhejiang 314001,China;Department of General Surgery,Zhejiang Xin’an International Hospital,Jiaxing,Zhejiang 314050,China)

机构地区：[1]浙江新安国际医院有限公司急诊科,浙江嘉兴314050 [2]嘉兴市中医医院肝胆科,浙江嘉兴314001 [3]浙江新安国际医院有限公司普外科,浙江嘉兴314050

出　　处：《中国现代医学杂志》2020年第4期114-118,共5页China Journal of Modern Medicine

摘　　要：目的研究急性化脓性胆管炎(APC)患者血清免疫抑制酸性蛋白(IAP)水平,并探讨其临床意义。方法选取2017年1月—2018年12月浙江新安国际医院有限公司和嘉兴市中医医院收治的APC患者160例作为APC组,同期健康体检者160例作为对照组。测定IAP、中性粒细胞、淋巴细胞、C反应蛋白(CRP)、白细胞计数(WBC)、碱性磷酸酶(ALP)及直接胆红素(DBIL)水平,计算中性粒细胞/淋巴细胞比值(NLR)。结果APC组治疗前IAP、CRP、WBC、ALP及DBIL水平和NLR值高于对照组(P<0.05)。重症组血清IAP、CRP、WBC、ALP、DBIL及NLR高于轻症组(P<0.05)。APC组治疗后血清IAP、CRP、WBC、ALP、DBIL及NLR低于治疗前(P<0.05)。APC患者血清IAP水平与NLR、CRP、WBC、ALP及DBIL呈正相关(r=0.702、0.684、0.573、0.487和0.526,均P=0.000)。结论APC患者血清IAP水平升高,IAP水平在APC病情严重程度、炎症反应及疗效评估中具有一定指导价值。Objective To study the serum immunosuppressive acid protein(IAP)level in patients with acute suppurative cholangitis(APC)in order to explore its clinical significance.Methods Totally 160 patients with APC were selected as the APC group,and 160 healthy patients during the same period were selected as the control group(group C)from January 2017 to December 2018.The IAP,neutrophils,lymphocytes,C-reactive protein(CRP),WBC,alkaline phosphatase(ALP)and direct bilirubin(DBIL)levels were determined.The neutrophil/lymphocyte(NLR)values were calculated.Results Before treatment,the levels of serum IAP,NLR,CRP,WBC,ALP and DBIL in APC group were higher than those in group C(P<0.05).The levels of serum IAP,NLR,CRP,WBC,ALP and DBIL in the severe group were higher than those in the mild group(P<0.05).After treatment,the serum AAP,NLR,CRP,ALP and DBIL levels in APC patients were lower than those before treatment(P<0.05).The serum IAP levels in APC patients were positively correlated with NLR(r=0.702,P<0.05),CRP(r=0.684,P<0.05),WBC(r=0.573,P<0.05),ALP(r=0.487,P<0.05)and DBIL(r=0.526,P<0.05)levels.Conclusion The serum IAP level is elevated in patients with APC,and IAP level has certain guiding value in the severity of APC,inflammatory response and therapeutic effect evaluation.

关 键 词：胆管炎 急性病 C反应蛋白 白细胞计数 碱性磷酸酶 

分 类 号：R575.7[医药卫生—消化系统]