糖类抗原199、血小板计数和血清胱抑素C水平与急性梗阻性化脓性胆管炎病情严重程度的相关性  

The correlation between carbohydrate antigen 199,platelet count,and serum cystatin C levels with the severity of acute obstructive suppurative cholangitis

作　　者：赵杰[1] 蔡锋[1] 朱运海[1] 叶塞 李威威 孟松峰 赵培吉 Zhao Jie;Cai Feng;Zhu Yunhai;Ye Sai;Li Weiwei;Meng Songfeng;Zhao Peiji(Department of Gastroenterology,Shangqiu First People’s Hospital,Hepatobiliary Surgery,Shangqiu Clinical University,Xuzhou Medical University,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院/徐州医科大学商丘临床学院胃肠肝胆外科,商丘476100

出　　处：《中华实验外科杂志》2023年第12期2580-2583,共4页Chinese Journal of Experimental Surgery

基　　金：2020年河南省医学科技攻关计划项目(LHGJ20200935)。

摘　　要：目的探讨糖类抗原199(CA199)、血小板计数(PLT)和血清胱抑素C(Cys C)水平变化与急性梗阻性化脓性胆管炎(AOSC)病情严重程度的相关性。方法选取2019年5月至2023年5月商丘市第一人民医院接收的82例AOSC患者作为研究对象,所有患者根据病情严重程度分为AOSC组(A组),AOSC伴脓毒症组(B组),以及AOSC伴脓毒症休克组(C组)。采用电化学发光法检测患者血清CA199水平;采用全自动血细胞计数仪检测患者PLT水平;采用全自动生化分析仪检测患者血清Cys C水平;比较3组患者CA199、PLT、Cys C水平及阳性检出率;采用Pearson相关分析统计AOSC患者APACHEⅡ评分与CA199、PLT、Cys C的相关性;采用受试者工作特征(ROC)曲线分析CA199、PLT、Cys C对AOSC伴脓毒症、AOSC伴脓毒症休克的诊断价值。组间计量数据比较采用t检验,组间计数比较采用χ^(2)检验。结果C组患者CA199[(101.27±62.04)U/ml]和Cys C[(1.36±0.37)mg/L]水平明显高于B组[(61.10±41.07)U/ml、(0.99±0.32)mg/L,t=2.766、3.837,P<0.05],B组患者CA199和Cys C水平明显高于A组患者[(30.21±15.13)U/ml、(0.81±0.33)mg/L],差异有统计学意义(t=3.734、2.079,P<0.05)。C组患者PLT[(89.83±36.55)×10^(9)/L]水平明显低于B组[(148.66±62.31)×10^(9)/L,t=4.003,P<0.05],B组患者的PLT水平低于A组患者[(181.01±66.79)×10^(9)/L],但差异无统计学意义(t=1.874,P>0.05)。C组患者CA199[18例(75.00%)]、PLT[17例(70.83%)]、和Cys C[18例(75.00%)]阳性检出率明显高于B组[14例(48.28%),12例(41.38%),13例(44.83%)]和A组患者[11例(37.93%),8例(27.59%),9例(31.03%)],差异有统计学意义(t=3.920、2.144、2.219、7.283、9.856、10.16,P<0.05)。所有AOSC患者APACHEⅡ评分与CA199、Cys C水平呈正相关(r=0.456、0.593,P<0.05),与PLT水平呈负相关(r=-0.478,P<0.05)。CA199、PLT、Cys C对AOSC伴脓毒症诊断的ROC曲线面积分别为0.750、0.661和0.658(P<0.05),对AOSC伴脓毒症休克诊断的ROC曲线面积分别为0.868、0.856和0.859(P<0.05)。�Objective To investigate the the correlation between carbohydrate antigen 199(CA199),platelet count(PLT),and serum cystatin C(Cys C)levels with the severity of acute obstructive suppurative cholangitis(AOSC).Methods 82 AOSC patients admitted to Shangqiu First People’s Hospital from May 2019 to May 2023 were selected as the study subjects.All patients were divided into AOSC group(Group A),AOSC with sepsis group(Group B),and AOSC with sepsis shock group(Group C)based on the severity of the condition.Using electrochemiluminescence method to detect the serum CA199 level.Using a fully automatic blood cell counter to detect the patient’s PLT level.And the serum Cys C levels of patients was detected using a fully automated biochemical analyzer.compare the levels and positive detection rates of CA199,PLT,Cys C among three groups of patients.Using Pearson correlation analysis to analyze the correlation between APACHEⅡscore and CA199,PLT,Cys C in AOSC patients.The diagnostic value of CA199,PLT,and Cys C in AOSC with sepsis and AOSC with septic shock was analyzed using receiver operating characteristic curve(ROC curve).The comparison of inter group measurement data used t-test;Comparison of inter group counts usedχ^(2) Inspection.Results The levels of CA199[(101.27±62.04)U/ml]and Cys C[(1.36±0.37)mg/L]in group C were significantly higher than those in group B[(61.10±41.07)U/ml,(0.99±0.32)mg/L,t=2.766,3.837,P<0.05],while those in Group B were significantly higher than those in Group A patients[(30.21±15.13)U/ml,(0.81±0.33)mg/L,t=3.734,2.079,P<0.05].The PLT levels of patients in Group C[(89.83±36.55)×10^(9)/L]were significantly lower than those in Group B[(148.66±62.31)×10^(9)/L,t=4.003,P<0.05],while those in Group B were lower than those in Group A[(181.01±66.79)×10^(9)/L,t=1.874,P>0.05].The positive detection rates of CA199[18 cases(75.00%)],PLT[17 cases(70.83%)],and Cys C[18 cases(75.00%)]in Group C were significantly higher than those in Group B[14 cases(48.28%),12 cases(41.38%),13 cases(44.83%)]and Gro

关 键 词：急性梗阻性化脓性胆管炎 糖类抗原199 血小板计数 胱抑素C 

分 类 号：R575.7[医药卫生—消化系统]