背景：这项研究根据2018年东京指南评估了不同实验室指标对急性胆管炎（AC）严重程度的预测价值。
目的：我们从2016年6月至2021年5月连续纳入诊断为AC的患者。血清降钙素原(PCT)和C反应蛋白(CRP)水平,白细胞计数,中性粒细胞-淋巴细胞比率，并根据AC的严重程度比较血小板淋巴细胞比率（PLR）。
结果：总计，293名患者参加了这项研究(轻度，n=172；中等，n=68；严重，n=53）。在接收机工作特性分析中，CRP是区分轻度和中度AC的最佳生物标志物（曲线下面积[AUC]0.66，95％置信区间[CI]0.58-0.74）。PCT是区分轻度和重度AC的最佳生物标志物（AUC0.80，95％CI0.74-0.86）。117例（39.93%）进行血培养，其中53人(45.30%)有阳性结果。关于血培养阳性，PLR最具预测性（AUC0.85，95%CI0.78-0.92）。
结论：PCT可作为重度AC的可靠预测指标。CRP最能预测中度AC，而PLR最能预测血培养阳性。
This study evaluated the predictive value of different laboratory indicators for the severity of acute cholangitis (AC) according to the 2018 Tokyo
Guidelines.
We enrolled consecutive patients with a diagnosis of AC from June 2016 to May 2021. Serum procalcitonin (PCT) and C-reactive protein (CRP) levels, white blood cell counts, the neutrophil-lymphocyte ratio, and the platelet-lymphocyte ratio (PLR) were compared according to the severity of AC.
In total, 293 patients were enrolled in this study (mild, n = 172; moderate, n = 68; severe, n = 53). In receiver operating characteristic analyses, CRP was the best biomarker for differentiating mild and moderate AC (area under the curve [AUC] 0.66, 95% confidence interval [CI] 0.58-0.74). PCT was the best biomarker for differentiating mild and severe AC (AUC 0.80, 95% CI 0.74-0.86). Blood culture was performed in 117 patients (39.93%), 53 of whom (45.30%) had positive results. Regarding blood culture positivity, PLR was most predictive (AUC 0.85, 95% CI 0.78-0.92).
PCT can be used as a reliable predictor of severe AC. CRP was most predictive of moderate AC, whereas PLR was most predictive of blood culture positivity.
