血清C反应蛋白、降钙素原和淀粉样蛋白A对急性梗阻性化脓性胆管炎诊断的价值  

The value of serum C-reactive protein,procalcitonin and amyloid protein A in the diagnosis of acute obstructive suppurative cholangitis

作　　者：柳光霞[1] 李永坤[1] Liu Guangxia;Li Yongkun(Department of General Surgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院普通外科,南阳473000

出　　处：《中华实验外科杂志》2024年第3期564-567,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨血清C反应蛋白、降钙素原和淀粉样蛋白A对急性梗阻性化脓性胆管炎的诊断价值。方法选取2020年1月至2023年8月南阳医学高等专科学校第一附属医院收治的91例急性梗阻性化脓性胆管炎患者作为研究对象(观察组),同时选取45例健康者作为对照对象(对照组)。根据患者的疾病严重程度,分为胆管炎组,合并脓毒症组和合并脓毒症休克组。采用免疫比浊法测定血清C反应蛋白水平;采用免疫荧光发光法测定血清降钙素原水平;采用胶乳增强免疫比浊法测定淀粉样蛋白A水平。分析对照组和观察组以及不用疾病严重程度患者之间血清C反应蛋白、降钙素原和淀粉样蛋白A水平。绘制受试者工作特征曲线,计算工作曲线下面积,分析血清C反应蛋白、降钙素原和淀粉样蛋白A单独或者联合使用对急性梗阻性化脓性胆管炎诊断的价值。组间计量数据比较采用t检验。结果对照组血清中C反应蛋白、降钙素原和淀粉样蛋白A水平[(1.77±0.81)mg/L、(0.21±0.07)ng/ml、(5.01±0.78)mg/L]明显低于急性梗阻性化脓性胆管炎患者[(12.91±5.99)mg/L、(2.06±1.04)ng/ml、(192.08±82.64)mg/L],差异有统计学意义(t=12.330、12.330、15.380,P<0.05)。胆管炎组患者血清C反应蛋白、降钙素原和淀粉样蛋白A水平[(7.07±1.36)mg/L、(0.99±0.11)ng/ml、(96.43±11.33)mg/L]明显低于合并脓毒症组患者[(11.57±1.36)mg/L、(1.91±0.24)ng/ml、(190.54±20.79)mg/L],差异有统计学意义(t=7.287、19.150、21.850,P<0.05)。合并脓毒症组患者血清C反应蛋白、降钙素原和淀粉样蛋白A水平[(11.57±1.36)mg/L、(1.91±0.24)ng/ml、(190.54±20.79)mg/L]明显低于合并脓毒症休克组患者[(20.08±1.36)mg/L、(3.39±0.24)ng/ml、(292.58±28.22)mg/L],差异有统计学意义(t=10.940、11.300、16.120,P<0.05)。血清C反应蛋白单独诊断急性梗阻性化脓性胆管炎合并脓毒症或脓毒症休克的曲线下面积为0.88,敏感度为89.00%,�Objective To investigate the value of serum C-reactive protein,procalcitonin and amyloid protein A in the diagnosis of acute obstructive suppurative cholangitis.Methods A total of 91 patients with acute obstructive suppurative cholangitis admitted to our hospital from January 2020 to August 2023 were selected as the research objects(observation group),and 45 healthy people were selected as the control objects(control group).According to the severity of the disease,the patients were divided into cholangitis subgroup,cholangitis combined with sepsis subgroup and cholangitis combined with septic shock subgroup.The serum C-reactive protein level was measured by immune turbidimetric method.The serum procalcitonin level was measured by immunofluorescence method.The amyloid protein A level was measured by latex enhanced immune turbidimetric method.The serum C-reactive protein,procalcitonin and amyloid protein A levels between the control group and the observation group were analyzed,as well as those between patients without disease severity.????The receiver operating characteristic curve was drawn,the area under the curve was calculated,and the value of serum C-reactive protein,procalcitonin and amyloid protein A alone or in combination in the diagnosis of acute obstructive suppurative cholangitis was analyzed.The t test was used for comparison of measurement data between groups.ResultsThe levels of serum C-reactive protein,procalcitonin and amyloid A in the control group[(1.77±0.81)mg/L,(0.21±0.07)ng/ml,(5.01±0.78)mg/L]were significantly lower than those in the patients with acute obstructive suppurative cholangitis[(12.91±5.99)mg/L,(2.06±1.04)ng/ml,(192.08±82.64)mg/L,t=12.330,12.330,15.380,P<0.05].The levels of serum C-reactive protein,procalcitonin and amyloid A in the patients with cholangitis[(7.07±1.36)mg/L,(0.99±0.11)ng/ml,(96.43±11.33)mg/L]were significantly lower than those in the patients with sepsis[(11.57±1.36)mg/L,(1.91±0.24)ng/ml,(190.54±20.79)mg/L,t=7.287,19.150,21.850,P<0.05].The levels of se

关 键 词：血清C反应蛋白 降钙素原 淀粉样蛋白A 急性梗阻性化脓性胆管炎 

分 类 号：R575.7[医药卫生—消化系统]