摘要
目的 探讨联合检测血清可溶性髓系细胞触发受体-1(sTREM-1)和降钙素原(PCT)对老年胆道结石术后继发急性胆管炎(AC)的预测价值。方法 以2019年1月至2022年9月收治的145例行胆道结石术的老年病人作为研究对象,按术后是否继发AC将病人分为对照组(未继发AC,n=56)和观察组(继发AC,n=89),再根据AC病情程度将观察组病人分为轻度(n=37)、中度(n=29)和重度(n=23)3个亚组。检测各组病人血清WBC、CRP、PCT和sTREM-1水平并进行比较。采用Logistic回归分析继发AC以及AC严重程度的影响因素;绘制ROC曲线分析PCT和sTREM-1水平对老年胆道结石术后继发AC的预测效能。结果 与对照组比较,观察组血清WBC、CRP、PCT和sTREM-1水平显著升高(P<0.01)。与轻度组比较,中度组和重度组病人血清CRP、PCT和sTREM-1水平均显著升高;与中度组比较,重度组病人血清WBC和PCT水平显著升高(均P<0.05)。Logistic回归分析结果显示,血清CRP、PCT和sTREM-1水平升高是老年胆道结石术后继发AC和AC重症的独立危险因素(均P<0.05)。ROC曲线评估结果显示,血清PCT和sTREM-1联合检测对术后继发AC以及AC严重程度的预测效能均显著高于单一指标(均P<0.05)。结论 胆道结石术后继发AC的老年病人血清PCT和sTREM-1水平明显升高,二者联合检测对胆道结石术后继发AC具有预测价值。
Objective To investigate the predictive value of serum soluble myeloid cell trigger receptor-1(sTREM-1)and procalcitonin(PCT)for secondary acute cholangitis(AC)in the elderly patients undergoing biliary calculi surgery.Methods A total of 145 elderly patients undergoing biliary calculus surgery from January 2019 to September 2022 were enrolled in this study,and the patients were divided into control group(without postoperative AC,n=56)and observation group(with postoperative AC,n=89).According to the degree of AC,the observation group was divided into three subgroups:mild group(n=37),moderate group(n=29)and severe group(n=23).The serum levels of white blood cells(WBC),C-reactive protein(CRP),PCT and sTREM-1 were detected and compared among the groups.Logistic regression was used to analyze the influencing factors of secondary AC and the severity.ROC curve was drawn to analyze the predictive efficiency of PCT and sTREM-1 levels for secondary AC in the elderly patients undergoing biliary caculi surgery.Results Compared with control group,the serum levels of WBC,CRP,PCT and sTREM-1 in observation group were significantly increased(P<0.01).Compared with mild group,the serum CRP,PCT and sTREM-1 levels in moderate group and severe group were significantly increased;Compared with moderate group,the serum levels of WBC and PCT in severe group were significantly increased(all P<0.05).Logistic regression analysis showed that the serum levels of CRP,PCT and sTREM-1 were the independent risk factors of postoperative AC and severe degree in the elderly patients(all P<0.05).ROC curve results showed that the combination detection of serum PCT and sTREM-1 showed higher predicting efficiency than single detection of them in predicting the incidence of postoperative AC and the severe degree(all P<0.05).Conclusions The serum PCT and sTREM-1 levels in the elderly patients with secondary AC after biliary calculi operation are significantly increased,and the combined detection of PCT and sTREM-1 has good predictive value for the incidence of postoperative AC.
作者
石毅
高骥
王鹏
芮一奇
白剑峰
SHI Yi;GAO Ji;WANG Peng;RUI Yiqi;BAI Jianfeng(Hepatobiliary Center,Jiangsu Province Hospital,Nanjing 210029,China;Department of General Surgery,Jiangsu Province Official Hospital,Nanjing 210024,China)
出处
《实用老年医学》
CAS
2024年第7期713-717,共5页
Practical Geriatrics
基金
国家自然科学基金资助项目(82101873)。
