NT-proBNP、PCT及血清钙与胆管结石继发急性梗阻化脓性胆管炎病情程度的相关性  

Correlation of NT-proBNP,PCT and Serum Calcium with Acute Obstructive Suppurative Cholangitis Secondary to Bile Duct Stones

作　　者：白伟 李帅 BAI Wei;LI Shuai(Shangqiu City Hospital Laboratory,Shangqiu 476000,Henan Province,China;Clinical Laboratory,Henan Hongli Hospital,Xinxiang 45300,Henan Province,China)

机构地区：[1]商丘市立医院检验科,河南商丘476000 [2]河南宏力医院检验科,河南新乡453000

出　　处：《罕少疾病杂志》2024年第2期68-70,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨N末端脑利钠肽前体(NT-pro BNP)、降钙素原(PCT)及血清钙与胆管结石继发急性梗阻化脓性胆管炎(AOSC)病情程度的相关性。方法根据术后1周内是否出现脓毒症或脓毒症性休克,将患者分为轻度组(仅继发性AOSC),中度组(AOSC合并脓毒症),重度组(AOSC合并脓毒症性休克)。采用Spearman相关性分析NT-pro BNP、PCT及血清钙与入院24 h AOSC严重程度的关系,用受试者工作特征曲线(ROC)分析三指标对AOSC合并脓毒症的预测。结果入院24 h时,轻、中、重度组NT-pro BNP、PCT水平依次升高,血清钙水平依次降低(P<0.05);Spearman相关性显示,NT-pro BNP、PCT与入院24 h AOSC严重程度呈正相关(r=0.600、0.615,P<0.05),与血清钙呈负相关(r=-0.516,P<0.05)。ROC曲线显示,NT-pro BNP、PCT及血清钙对AOSC合并脓毒症预测AUC为0.905,对AOSC合并脓毒症性休克预测AUC为0.882,三者联合预测效能高于单项检测。结论NT-pro BNP、PCT与胆管结石继发AOSC病情程度呈正相关,与血清钙呈负相关,三指标联合检测对AOSC病情进展程度具有较高的预测价值。Objective To investigate the correlation between N-terminal brain natriuretic peptide precursor(NT-proBNP),procalcitonin(PCT)and serum calcium and the severity of acute obstructive suppurative cholangitis(AOSC)secondary to bile duct stones.Methods Patients were divided into a mild group(only secondary AOSC),a moderate group(AOSC with sepsis),and a severe group(AOSC with sepsis)according to whether they developed septic or septic shock within 1 week after surgery.Spearman correlation was used to analyze the relationship between NT-proBNP,PCT and serum calcium and the severity of AOSC 24 h after admission,and receiver operating characteristic curve(ROC)was used to analyze the prediction of AOSC combined with sepsis.Results 24 h after admission,the levels of NT-proBNP and PCT in mild,moderate and severe groups were increased successively,while the serum calcium levels were decreased successively(P<0.05).Spearman correlation showed that NT-proBNP and PCT were positively correlated with AOSC severity at 24 h after admission(r=0.600,0.615,P<0.05),and negatively correlated with serum calcium(r=-0.516,P<0.05).ROC curve showed that the AUC predicted by NT-proBNP,PCT and serum calcium for AOSC combined with sepsis was 0.905,and for AOSC combined with septic shock was 0.882.The combined prediction efficiency of the three tests was higher than that of single test.Conclusion NT-proBNP and PCT were positively correlated with the degree of AOSC secondary to bile duct stones,and negatively correlated with serum calcium.The combined detection of the three indicators had a high predictive value for the degree of AOSC progression.

关 键 词：胆管结石 急性梗阻化脓性胆管炎 N末端脑利钠肽前体 降钙素原 血清钙 病情程度 

分 类 号：R575.7[医药卫生—消化系统]