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侯晓敏.血清降钙素原和C反应蛋白联合检测对老年人急性胆管炎严重程度的评估价值[J].同济大学学报（医学版）,2018,39(2):112-116,122. [点击复制]
HOU Xiao-min.Combined detection of serum procalcitonin and C reactive protein in severity classification of elderly patients with acute cholangitis[J].同济大学学报（医学版）,2018,39(2):112-116,122. [点击复制]

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血清降钙素原和C反应蛋白联合检测对老年人急性胆管炎严重程度的评估价值
侯晓敏
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(上海市普陀区人民医院普外科，上海200060)

摘要:

目的探讨联合检测血清降钙素原（procalcitonin, PCT）和C反应蛋白（C reactive protein, CRP）在急性胆管炎严重程度分级中的临床意义。方法选取2012年1月至2017年3月在上海市普陀区人民医院普外科住院的89例急性胆管炎住院老年患者，其中轻度急性胆管炎31例，中度急性胆管炎37例，重度急性胆管炎21例。对照组为同期无感染的慢性胆囊炎患者（30例）。比较3组急性胆管炎和对照组PCT、CRP和白细胞（white blood cell, WBC）计数结果。结果急性胆管炎（轻、中、重度）三组的PCT、CRP、WBC均高于对照组（P＜0.05）。PCT、CRP在急性胆管炎三组之间比较，差异有统计学意义（P＜0.05）。WBC计数在急性胆管炎三组之间比较，差异无统计学意义（P>0.05）。血清PCT指标灵敏度、特异度和ROC曲线下的面积值均优于CRP；联合检测血清PCT、CRP的灵敏度、特异度和ROC曲线下的面积值优于各指标独立检测。结论血清PCT、CRP浓度与老年人急性胆管炎严重程度呈正相关，可以在疾病早期判别急性胆管炎严重程度。联合检测血清PCT、CRP判别老年人急性胆管炎严重程度可以提高其诊断的灵敏度以及特异度。

关键词: 降钙素原 C反应蛋白急性胆管炎

DOI：10.16118/j.1008-0392.2018.02.022

投稿时间：2017-07-05

基金项目:

Combined detection of serum procalcitonin and C reactive protein in severity classification of elderly patients with acute cholangitis

HOU Xiao-min

(Dept. of General Surgery, Shanghai Putuo Distric People’s Hospital, Shanghai 200060, China)

Abstract:

ObjectiveTo investigate the clinical significance of combined detection of serum procalcitonin (PCT) and C reactive protein (CRP) in grading the severity of elderly patients with acute cholangitis. MethodsFrom January 2012 to March 2017, 89 elderly patients with acute cholangitis admitted to Department of General Surgery of Shanghai Putuo District Peoples Hospital were enrolled, including 31 cases of mild acute cholangitis, 37 cases of moderate acute cholangitis, and 21 cases of severe acute cholangitis. The control group was 30 cases with chronic cholecystitis. Serum PCT, CRP levels and WBC counts in 3 groups of acute cholangitis and control group were compared. ResultsThe levels of PCT, CRP and WBC in three groups of acute cholangitis (mild, moderate, and severe) were higher than those in the control group (P<0.05). The difference of PCT and CRP among three groups of acute cholangitis was statistically significant (P<0.05). There was no statistically significant difference in WBC counts among the three groups of acute cholangitis (P>0.05). The sensitivity and specificity and the area under ROC curve of PCT index were better than those of CRP. When the serum concentrations of PCT and CRP were combined for acute cholangitis, the sensitivity and specificity and the area under ROC curve were better than those of CRP or PCT alone. ConclusionThe serum levels of PCT and CRP were positively correlated with the severity of acute cholangitis in the elderly. They can distinguish the severity of acute cholangitis in the early stage of disease. The sensitivity and specificity of combined detection of serum PCT and CRP in identifying the severity of acute cholangitis in elderly patients can be improved.

Key words: procalcitonin C reactive protein acute cholangitis