急性化脓性胆管炎患者血清免疫抑制酸性 蛋白水平的变化及其临床意义

Changes of serum immunosuppressive acidic protein levels in patients with acute suppurative cholangitis and its clinical significance

摘要:

目的 研究急性化脓性胆管炎（APC）患者血清免疫抑制酸性蛋白（IAP）水平，并探讨其临床 意义。方法 选取2017 年1 月—2018 年12 月浙江新安国际医院有限公司和嘉兴市中医医院收治的APC 患 者160 例作为APC组，同期健康体检者160 例作为对照组。测定IAP、中性粒细胞、淋巴细胞、C反应蛋白（CRP）、 白细胞计数（WBC）、碱性磷酸酶（ALP）及直接胆红素（DBIL）水平，计算中性粒细胞/ 淋巴细胞比值 （NLR）。结果 APC 组治疗前IAP、CRP、WBC、ALP 及DBIL 水平和NLR 值高于对照组（P <0.05）。重 症组血清IAP、CRP、WBC、ALP、DBIL 及NLR 高于轻症组（P <0.05）。APC 组治疗后血清IAP、CRP、 WBC、ALP、DBIL 及NLR 低于治疗前（P <0.05）。APC 患者血清IAP 水平与NLR、CRP、WBC、ALP 及 DBIL 呈正相关（r =0.702、0.684、0.573、0.487 和0.526，均P =0.000）。结论 APC 患者血清IAP 水平升高， IAP 水平在APC 病情严重程度、炎症反应及疗效评估中具有一定指导价值。

Abstract:

Objective To study the serum immunosuppressive acid protein (IAP) level in patients with acute suppurative cholangitis (APC) in order to explore its clinical significance. Methods Totally 160 patients with APC were selected as the APC group, and 160 healthy patients during the same period were selected as the control group (group C) from January 2017 to December 2018. The IAP, neutrophils, lymphocytes, C-reactive protein (CRP), WBC, alkaline phosphatase (ALP) and direct bilirubin (DBIL) levels were determined. The neutrophil/lymphocyte (NLR) values were calculated. Results Before treatment, the levels of serum IAP, NLR, CRP, WBC, ALP and DBIL in APC group were higher than those in group C (P < 0.05). The levels of serum IAP, NLR, CRP, WBC, ALP and DBIL in the severe group were higher than those in the mild group (P < 0.05). After treatment, the serum AAP, NLR, CRP, ALP and DBIL levels in APC patients were lower than those before treatment (P < 0.05). The serum IAP levels in APC patients were positively correlated with NLR(r = 0.702, P < 0.05), CRP(r = 0.684, P < 0.05), WBC(r = 0.573, P < 0.05), ALP(r = 0.487, P < 0.05) and DBIL(r = 0.526, P < 0.05) levels. Conclusion The serum IAP level is elevated in patients with APC, and IAP level has certain guiding value in the severity of APC, inflammatory response and therapeutic effect evaluation.