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血清糖链抗原19-9对梗阻性黄疸患者发生急性胆管炎的预测价值
Predictive value of serum CA19-9 in predicting acute cholangitis in patients with obstructive jaundice
文章发布日期:2016年07月06日  来源:  作者:潘亚军,孙少甫  点击次数:864次  下载次数:232次

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【摘要】:目的探讨梗阻性黄疸患者发生急性胆管炎的预测因子。方法回顾性分析海口市第四人民医院2010年10月-2015年10月收治的358例胆总管结石合并梗阻性黄疸患者的临床资料。根据患者是否发生急性胆管炎,分为急性胆管炎组(n=223)和梗阻性黄疸组(n=135)。比较两组患者的年龄、性别和合并症,评估血清肿瘤标志物及肝功能指标的异常与急性胆管炎发生的关系。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。选取有统计学意义的指标构建受试者工作特征曲线(ROC),评价其对急性胆管炎诊断的敏感度和特异度。结果急性胆管炎组血清糖链抗原(CA)19-9、CA12-5水平明显高于梗阻性黄疸组[(82.33±23.01) kU/L vs (36.75±12.58) kU/L, (30.21±9.59) kU/L vs (18.62±5.27) kU/L],差异均有统计学意义(t值分别为11.028、8.597,P值均<0.001)。ROC曲线分析显示,血清CA19-9、CA12-5曲线下面积分别为0.891、0.705,对应诊断准确度最高的临界值分别为61.01 kU/L、22.56 kU/L,敏感度分别为82.1%、77.6%,特异度分别为79.8%、69.5%。结论血清CA19-9升高对胆总管结石合并梗阻性黄疸发生急性胆管炎有较大的预测价值。
【Abstract】:ObjectiveTo investigate the predictive factors for acute cholangitis in patients with obstructive jaundice. MethodsA retrospective analysis was performed for the clinical data of 358 patients with common bile duct stones and obstructive jaundice who were treated in The Fourth People′s Hospital of Haikou from October 2010 to October 2015. According to the presence or absence of acute cholangitis, the patients were divided into acute cholangitis group(n=223) and obstructive jaundice group(n=135). Age, sex, and comorbidities were compared between the two groups, and the association between abnormalities in serum tumor markers and liver function parameters and the development of acute cholangitis was examined. The parameters with statistical significance were used to establish the receiver operating characteristic (ROC) curves, and their sensitivity and specificity in the diagnosis of acute cholangitis were evaluated. The t test and χ2 test were applied for comparison of continuous data and categorical data between groups, respectively. ResultsThe acute cholangitis group had significantly higher serum levels of CA19-9 and CA12-5 than the obstructive jaundice group (serum level of CA19-9: 82.33±23.01 kU/L vs 36.75±12.58 kU/L, t=11.028, P<0.05; serum level of CA125: 30.21±9.59 kU/L vs 18.62±5.27 kU/L, t=8.597, P<005). The analysis of the ROC curves showed that the areas under the ROC curve for serum CA19-9 and CA12-5 were 0.891 and 0705, respectively, and the corresponding cut-off values for the highest diagnostic accuracy were 61.01 kU/L and 22.56 kU/L, respectively, with sensitivities of 82.1% and 77.6% and specificities of 79.8% and 69.5%. ConclusionIncreased serum CA19-9 level has a great value in predicting acute cholangitis in patients with common bile duct stones and obstructive jaundice.
【关键字】:黄疸, 阻塞性; 胆管炎; CA-19-9抗原
【Key words】:jaundice, obstructive; cholangitis; CA-19-9 antigen
【引证本文】:潘亚军, 孙少甫. 血清糖链抗原19-9对梗阻性黄疸患者发生急性胆管炎的预测价值[J]. 临床肝胆病杂志, 2016, 32(8): 1553-1556.

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