目的 探讨胆道梗阻合并急性胆道感染患者血清降钙素原(procalcitonin,PCT)、高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、瘦素及可溶性瘦素受体(soluble leptin receptor,sLR)水平变化,为胆道梗阻合并急性胆道感染的临床诊断提供参考.方法 选取2016年1月至2016年7月于本院确诊并治疗的83例胆道梗阻患者为研究对象,将53例胆汁培养阳性且伴随发热、腹痛等临床症状的患者纳入感染组,将30例胆汁培养阴性、单独真菌感染及胆汁培养阳性但无发热、腹痛等症状者纳入对照组.比较两组患者入院时血清PCT、hs-CRP、瘦素及sLR水平变化.结果 感染组患者血清PCT、hs-CRP及瘦素水平均明显高于对照组(P<0.05),sLR水平低于对照组(P<0.05).感染组中胆囊及肝外胆管梗阻患者hs-CRP水平高于肝内胆管梗阻患者(t=0.521,P=0.604),两类患者血清PCT、瘦素及sLR水平比较均无显著差异(P>0.05).对照组中胆囊及肝外胆管梗阻和肝内胆管梗阻患者的hs-CRP、PCT、瘦素及sLR水平比较均无显著差异(P>0.05).结论 胆道感染患者血清PCT、hs-CRP、瘦素及sLR水平是诊断胆道梗阻所致急性胆道感染的重要指标,其中hs-CRP水平与胆囊及肝外胆管梗阻所致感染相关.%Objective To evaluate the serum levels of procalcitonin (PCT), high sensitive C-reactive protein (hs-CRP), leptin and its soluble leptin receptor (sLR) in patients with biliary obstruction complicated with acute biliary tract infection, and to analyze the value of them in diagnosis.Method A total of 83 patients with biliary tract infection from January 2016 to July 2016 who were diagnosed and treated in our hospital were selected as the subjects. 53 patients with positive bile culture, fever and abdominal pain were enrolled into infection group, and 30 patients with negative bile culture, fungus infection, or positive bile culture but no fever or abdominal pain were enrolled into control group. Blood samples were collected for measuring the levels of PCT, hs-CRP, leptin and sLR when both groups patients on admission.Result The serum levels of PCT, hs-CRP and leptin in infection group were significantly higher than control group (P<0.05), the level of sLR was significantly lower than control group (P<0.05). In infection group, the level of hs-CRP in patients with gallbladder and extrahepatic bile duct obstruction was higher than that in patients with intrahepatic bile duct obstruction (t=0.521,P=0.604), there were no significant differences in serum levels of PCT, leptin and sLR between patients with gallbladder and extrahepatic bile duct obstruction and intrahepatic bile duct obstruction in infection group (P>0.05). There were no significant differences of serum levels of hs-CRP, PCT, leptin and sLR between patients with gallbladder and extrahepatic bile duct obstruction and intrahepaticbile duct obstruction in control group (P>0.05).Conclusion The levels of serum PCT, hs-CRP, leptin and sLR in patients with biliary tract infection are important indicators for the diagnosis of acute biliary tract infection caused by biliary obstruction, in which the level of hs-CRP is related to the infection of gallbladder and extrahepatic bile duct obstruction.
展开▼
