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.