摘要
目的 探讨降钙素原（procalcitonin,PCT）在内镜下乳头括约肌切开术后反流性胆管炎中的诊治价值.方法 对30例反流性胆管炎患者行血培养、胆汁细菌培养检查,检测治疗前及治疗后PCT、C反应蛋白（creaction protein,CRP）、白细胞（WBC）值,比较各项指标的阳性率并分析PCT、CRP和WBC的比值变化与感染是否控制的关系.结果 PCT的阳性率为96.67％,CRP的阳性率为93.34％,WBC的阳性率为70.00％,血培养的阳性率为40.00％,胆汁培养的阳性率为100％.其余4种检查阳性率均高于血培养阳性率（P ＜0.05）;PCT、CRP、胆汁培养阳性率比较差异无统计学意义（P =0.355）,但均高于WBC的阳性率（P＜0.05）.治疗前后,PCT及CRP的变化差异有统计学意义（P =0.030,P＜0.001）,WBC的变化差异无统计学意义（P =0.132）.PCT比值对感染控制的判断优于CRP,ROC曲线下面积为0.847（95％ CI：0.687 ～1.007,P=0.010）,其判断感染控制的阈值为0.847（灵敏度为70.8％,特异度为83.3％）.结论 PCT的检测在内镜下乳头括约肌切开术后反流性胆管炎诊断中是一个灵敏度很高的炎症指标,同时PCT比值的变化可以判断感染是否控制.
Objective To discuss the clinical value of procalcitonin in diagnosing and treating refluxing cholangitis after endoscopic sphincterotomy.Methods A total of 30 patients with refluxing cholangitis after endoscopic sphincterotomy were enrolled in this study.Blood culture and bile bacterial culture were detected after admission.The procalcitonin （PCT）,C reactive protein（CRP） and white blood cell（WBC） were tested before and after anti-infective therapy.Results The positive rates of PCT,CRP,WBC,blood culture and bile bacterial culture were 96.67％,93.34％,70.00％,40.00％,100％ respectively.The positive rate of the other examination was higher than blood culture （P ＜ 0.05）.There was no difference among the PCT,CRP,and bile bacterial culture （P =0.355）,but all of these were higher than WBC （P ＜ 0.05）.The differences of the levels of PCT and CRP before and after the treatment were significant （P =0.030,P ＜ 0.001）,but the difference of the level of WBC was not significant （P =0.132）.Area under the curve （AUC） of procalcitonin to control infection was 0.847 （95％ CI：0.687 ～ 1.007,P =0.010）.The judging threshold of procalcitonin to control infection or not was 0.847 （sensitivity was 70.8％,specificity was 83.3％）.Conclusion PCT has a high sensitivity for the diagnosis of refluxing cholangitis after endoscopic sphincterotomy.The variation of PCT may be used to judge whether the infection is controlled.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第7期831-833,共3页
Chinese Journal of Gastroenterology and Hepatology
基金
深圳市龙岗区科技卫生项目(YS2013117)
关键词
降钙素原
反流性胆管炎
Procalcitonin
Refluxing cholangitis
