胆结石患者手术前后血清Ins、C-P、CA19-9水平与预后的关系  

Relationship between levels of serum Ins,C-P,and CA19-9before and after surgery and prognosis in patients with gallstones

作　　者：孙莉 敬思懿 SUN Li;JING Siyi(Department of Hepatobiliary and Pancreatic Surgery,the Third People's Hospital of Chengdu,Chengdu 610000,Sichuan,China)

机构地区：[1]成都市第三人民医院肝胆胰外科,四川成都610000

出　　处：《贵州医科大学学报》2022年第9期1102-1106,共5页Journal of Guizhou Medical University

基　　金：四川省卫生健康委员会科研课题(20PJ211)。

摘　　要：目的 探讨胆结石患者手术前后血清胰岛素(Ins)、C-肽(C-P)、癌抗原19-9(CA19-9)水平与患者预后的关系。方法 115例胆结石患者作为观察组,同期50例健康体检者作为对照组,分别测定观察组患者术前、术后第5天及对照组体检时的血清Ins、C-P、CA19-9水平,观察组根据手术疗效再分为预后良好组和预后不佳组;分别比较观察组术前与对照组、观察组手术前后、预后不佳组与预后良好组的血清Ins、C-P、CA19-9水平,采用受试者工作特征(ROC)曲线描述血清Ins、C-P、CA19-9水平对胆结石患者手术预后的预测价值,采用logistics回归方法分析观察组患者术后血清Ins、C-P、CA19-9水平与手术预后的关系。结果 观察组患者治疗前血清Ins、C-P、CA19-9水平高于对照组(P<0.05),观察组患者术后第5天血清Ins、C-P、CA19-9水平低于术前(P<0.05),预后不佳组患者术后第5天血清Ins、C-P、CA19-9水平高于预后良好组(P<0.05);ROC曲线显示,观察组术后第5天血清Ins、C-P、CA19-9三项指标联合检测对手术不良预后具有较高预测价值,其敏感度为0.875、特异度为0.787,ROC曲线下面积为0.905;logistics回归分析显示,血清Ins、C-P、CA19-9水平与胆结石手术患者预后有关(P<0.05)。结论 Ins、C-P、CA19-9与胆结石的发生及转归有关,血清三项指标联合检测对手术后患者的预后具有较高预测价值。Objective To explore the relationship between levels of serum insulin(Ins), C-peptide(C-P), and cancer antigen 19-9( CA19-9) before and after surgery and prognosis in patients with gallstones.Methods One hundred and fifteen patients with gallstones were selected as observation group and 50 healthy participants in physical examination during the same period served as control group. The levels of serum Ins, C-P, and CA19-9 of patients in observation group before surgery and on 5 d after surgery were measured and those of the participants in the control group during physical examination were surveyed. The patients in the observation group were further divided into good prognosis group and poor prognosis group according to the surgical efficacy. The levels of serum Ins,C-P and CA19-9 were compared between observation group and control group before surgery,observation group before and after surgery and between poor prognosis group and good prognosis group before and after surgery. Receiver operating characteristic( ROC) curves were used to describe the predictive value of serum Ins, C-P, and CA19-9 on surgical prognosis of patients with gallstones.Logistics regression method was used to analyze the relationship between levels of postoperative serum Ins, C-P, and CA19-9 and surgical prognosis.Results The levels of serum Ins, C-P, and CA19-9 of patients in observation group before treatment were higher compared with those in control group(P<0. 05). The levels of serum Ins, C-P, and CA19-9 of patients in observation group on 5 d after surgery were lower than those before surgery(P< 0. 05). The levels of serum Ins, C-P, and CA19-9 of patients in poor prognosis group were higher on 5 d after surgery compared to good prognosis group(P< 0. 05). ROC curves showed that the combined detection of the three indicators of serum Ins, CP, and CA19-9 on 5 d after surgery in observation group had a high predictive value on poor surgical prognosis, with sensitivity/specificity of 0. 875/0. 787 and corresponding area under the ROC curve

关 键 词：胆结石 胰岛素 C-肽 癌抗原19-9 预后 预测价值 

分 类 号：R657.4[医药卫生—外科学]