胆囊切除术前后CCK-A的表达水平及其临床意义  

Expression level of CCK-A before and after cholecystectomy and its clinical significance

作　　者：王瑞 陈虎 WANG Rui;CHEN Hu(Department of General Surgery,Sihong Hospital,Sihong 223900,China)

机构地区：[1]泗洪医院普外科,江苏泗洪223900

出　　处：《现代医学》2025年第2期223-228,共6页Modern Medical Journal

摘　　要：目的:探讨胆囊切除术前后血清胆囊收缩素受体A(CCK-A)表达水平及其在治疗胆结石中的临床疗效。方法:选取2022年1月至2023年12月在泗洪医院接受腹腔镜胆囊切除术的胆结石患者120例。检测患者术前和术后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和CCK-A水平。根据术后CCK-A表达水平的中位数将患者分为CCK-A高表达组(n=60)和CCK-A低表达组(n=60)。比较两组患者的临床指标,包括结石平均内径、手术时间、住院时间、术中出血量、肠蠕动恢复时间以及并发症发生率。结果:术后患者血清IL-6、TNF-α水平显著低于术前(P<0.05),而CCK-A水平显著升高(P<0.05)。与CCK-A低表达组相比,CCK-A高表达组患者的结石平均内径较小[(1.2±0.3)cm vs.(1.8±0.4)cm],手术时间较短[(45.6±8.2)min vs.(62.3±10.5)min],住院时间缩短[(3.2±0.5)d vs.(4.8±0.7)d],术中出血量减少[(15.3±3.2)mL vs.(25.6±4.8)mL],肠蠕动恢复时间缩短[(24.5±4.2)h vs.(36.8±6.5)h],并发症发生率降低(5.0%vs.15.0%),差异均具有统计学意义(均P<0.05)。结论:胆囊切除术可通过上调血清CCK-A表达,同时降低炎症因子IL-6、TNF-α水平,从而改善胆结石患者的临床预后。较高的CCK-A表达水平与更好的手术效果和更低的并发症发生率相关。Objective:To investigate expression level of serum cholecystokinin receptor A(CCK-A)before and after cholecystectomy and its clinical efficacy in the treatment of gallstones.Methods:A total of 120 patients with gallstones who underwent laparoscopic cholecystectomy in Sihong Hospital from January 2022 to December 2023 were selected to detect the levels of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and CCK-A before and after surgery.Patients were stratified into high CCK-A expression group(n=60)and low CCK-A expression group(n=60)based on the median postoperative CCK-A levels.Clinical parameters including mean stone diameter,operative time,length of hospital stay,intraoperative blood loss,time to bowel movement recovery,and complication rates were compared between the groups.Results:Postoperative serum levels of IL-6 and TNF-αwere significantly lower than preoperative levels(P<0.05),while CCK-A levels were significantly elevated(P<0.05).Compared with the low CCK-A expression group,the high CCK-A expression group demonstrated smaller mean stone diameter[(1.2±0.3)cm vs.(1.8±0.4)cm],shorter operative time[(45.6±8.2)min vs.(62.3±10.5)min],reduced hospital stay[(3.2±0.5)d vs.(4.8±0.7)d],decreased intraoperative blood loss[(15.3±3.2)mL vs.(25.6±4.8)mL],shorter time of bowel movement recovery[(24.5±4.2)h vs.(36.8±6.5)h],and lower complication rates(5.0%vs 15.0%).All differences were statistically significant(P<0.05).Conclusion:Cholecystectomy improves clinical outcomes in cholelithiasis patients through upregulating serum CCK-A expression and concurrently reducing inflammatory markers IL-6 and TNF-α.Higher CCK-A expression levels are correlated with better surgical outcomes and lower complication rates.

关 键 词：胆囊切除术 胆结石 胆囊收缩素受体A 炎症因子 临床效果 

分 类 号：R605[医药卫生—外科学]