摘要
目的探讨计算机断层扫描(CT)联合血清分泌型卷曲受体蛋白4(SFRP4)及可溶性生长刺激表达基因2蛋白(sST2)对恶性胆道梗阻(MBO)患者胆管支架置入术后并发胰腺炎的诊断价值。方法选取行胆管支架置入术的243例MBO患者为研究对象,根据术后并发胰腺炎情况分为胰腺炎组105例和无胰腺炎组138例。采用酶联免疫法检测SFRP4、sST2水平,采用受试者工作特征(ROC)曲线和四表格法分析SFRP4、sST2单独及联合CT诊断术后并发胰腺炎的临床价值。结果胰腺炎组血清SFRP4、sST2水平高于无胰腺炎组,差异有统计学意义(P<0.05);血清SFRP4、sST2水平诊断术后并发胰腺炎的曲线下面积(AUC)为0.694、0.667。CT诊断术后并发胰腺炎的敏感度为76.19%,特异度为60.87%;CT联合血清SFRP4、sST2水平诊断术后并发胰腺炎的敏感度为98.10%、准确度为76.54%;三者联合诊断的敏感度和准确度高于CT、SFRP4、sST2单独诊断,差异有统计学意义(P<0.05)。结论胆管支架置入术后并发胰腺炎的MBO患者血清SFRP4、sST2水平较高,CT联合血清SFRP4、sST2水平对术后并发胰腺炎具有较高的诊断价值。
Objective To investigate the diagnostic value of computer tomography(CT)combined with serum secreted frizzled-related protein 4(SFRP4)and soluble suppression of tumorigenicity 2(sST2)for pancreatitis after biliary duct stent implantation in patients with malignant biliary obstruction(MBO).Methods A total of 243 MBO patients with biliary duct stent implantation were selected as research objects,and they were divided into pancreatitis group with 105 cases and no pancreatitis group with 138 cases according to condition of postoperative complicated pancreatitis.Enzyme-linked immunosorbent assay was used to detect serum levels of SFRP4 and sST2,and the receiver operating characteristic(ROC)curve and the four table method were used to analyze the diagnostic values of serum SFRP4 or sST2 alone and their combination with CT for postoperative complicated pancreatitis.Results The serum levels of SFRP4 and sST2 in the pancreatitis group were significantly higher than those in the no pancreatitis group(P<0.05);the values of area under the curve(AUC)of serum SFRP4 and sST2 levels for diagnosis of postoperative complicated pancreatitis were 0.694 and 0.667,respectively.The sensitivity and specificity of CT for diagnosis of postoperative complicated pancreatitis were 76.19%and 60.87%,respectively;the sensitivity and accuracy of CT combined with serum SFRP4 and sST2 levels in diagnosing postoperative complicated pancreatitis were 98.10%and 76.54%,respectively;the sensitivity and accuracy of the combination of the three indexes for diagnosis were significantly higher than those of CT,SFRP4 or sST2 alone(P<0.05).Conclusion MBO patients with pancreatitis after biliary duct stent implantation have higher serum levels of SFRP4 and sST2,and CT combined with serum levels of SFRP4 and sST2 has high diagnostic value for postoperative complicated pancreatitis.
作者
柳群力
朱鸷翔
LIU Qunli;ZHU Zhixiang(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng,Henan,475000)
出处
《实用临床医药杂志》
CAS
2024年第5期59-62,67,共5页
Journal of Clinical Medicine in Practice
基金
河南省开封市科技发展计划项目(2103018)。
