摘要
目的探讨降钙素原和血小板的变化在胆总管结石治疗中的应用价值。方法对80例胆总管结石患者进行回顾性分析。根据SIRS诊断标准,将胆总管结石患者分为SIRS(n=40)组和非SIRS(n=40)组。在入院第1、3、5、7日检测降钙素原、白细胞、CRP、血小板。观察分析胆总管结石患者合并SIRS时对降钙素原、白细胞、CRP、血小板的影响并找出最佳判断SIRS的炎症指标。同时,通过计算APACHEⅡ评分,分析降钙素原和血小板的变化与胆总管结石患者的APACHEⅡ评分的关系。结果 SIRS是影响降钙素原、血小板变化的重要因素(P<0.01)。通过分析,降钙素原与血小板的ROC曲线下面积(AUC)分别为0.82、0.87,在SIRS患者的诊断方面,有较高的准确性。降钙素原、血小板与APACHEⅡ评分存在相关性(r分别为0.89、0.88,P均<0.01)。结论SIRS是影响降钙素原和血小板的重要因素;降钙素原是监测胆总管结石合并急性胆管炎的良好指标。联合监测降钙素原和血小板的变化对胆总管结石患者的早期诊断、病情严重度的判断和指导治疗方面具有重要意义。
Objective To investigate the application value of the changes of procalcitonin and platelet in the treatment of common bile duct stones. Methods Clinical data of 80 patients diagnosed with common bile duct stones were retrospectively analyzed. According to the diagnostic criteria of systemic inflammatory response syndrome（ SIRS）,all patients were divided into the SIRS（ n = 40） and non-SIRS groups（ n = 40）.The values of procalcitonin,white blood cell,C-reactive protein and platelet were detected at 1,3,5 and 7 d after admission. The effect of common bile duct stones complicated with SIRS upon these parameters was evaluated. The optimal inflammatory parameters of SIRS were identified. The score of APACHE Ⅱ was calculated.The relationship between the changes of procalcitonin and platelet and APACHE Ⅱ score was investigated. Results SIRS was a factor affecting the changes of procalcitonin and platelet（ both P〈0. 01）. The area under the ROC curve of procalcitonin and platelet was 0. 82 and 0. 87,which had a relatively high accuracy in the diagnosis of SIRS. The changes of procalcitonin and platelet were significantly correlated with APACHE Ⅱ score（ r = 0. 89 and 0. 88,both P〈0. 01）. Conclusions SIRS is a pivotal factor affecting procalcitonin and platelet. Procalcitonin is an appropriate index for monitoring common bile duct stones complicated with acute cholangitis. Monitoring the changes of procalcitonin and platelet plays a vital role in the early diagnosis of common bile duct stones,assessment of the severity of diseases and offering guidance to clinical treatment.
出处
《新医学》
2017年第2期124-127,共4页
Journal of New Medicine
关键词
胆总管结石
降钙素原
血小板
Common bile duct stone
Procalcitonin
Platelet
