摘要
目的:探讨急性梗阻性化脓性胆管炎(AOSC)患者血清前蛋白酶(Presepsin)、免疫抑制酸性蛋白(IAP)、高迁移率族蛋白B1(HMGB1)与经皮肝穿刺胆道引流术(PTCD)治疗预后的关系.方法:选取2021年1月～2023年1月保定市第二中心医院收治220例接受PTCD治疗的AOSC患者纳入AOSC组,另选取同期体检健康志愿者88名纳入对照组.根据AOSC患者PTCD术后住院期间是否死亡分为存活组36例和死亡组184例.检测血清Presepsin、IAP、HMGB1水平.采用多因素Logistic回归模型分析影响AOSC患者PTCD治疗预后的因素,受试者工作特征(ROC)曲线分析血清Presepsin、IAP、HMGB1水平对AOSC患者PTCD术后死亡的预测价值.结果:AOSC组血清Presepsin、IAP、HMGB1水平高于对照组(P＜0.05).220例AOSC患者PTCD术后住院期间死亡率为16.36％(36/220).多因素Logistic回归分析显示,发病至手术时间≥3d、术后24h胆汁引流量＜300 mL、Presepsin升高、IAP升高、HMGB1升高为影响AOSC患者PTCD治疗预后的独立危险因素(P＜0.05).ROC曲线分析显示,血清Presepsin、IAP、HMGB1水平联合预测AOSC患者PTCD术后死亡的曲线下面积为0.920,大于单一指标预测.结论:AOSC患者血清Presepsin、IAP、HMGB1水平升高,是PTCD治疗预后的独立危险因素.血清Presepsin、IAP、HMGB1水平联合预测AOSC患者PTCD治疗预后的价值较高.
Abstract
Objective:To investigate the relationship between serum Presepsin,immunosuppressive acid protein(IAP),high mo-bility group B1(HMGB1)and prognosis of percutaneous transhepatic cholangial drainage(PTCD)treatment in patients with acute ob-structive suppurative cholangitis(AOSC).Methods:220 patients with AOSC who received PTCD treatment in the Baoding Second Cen-tral Hospital from January 2021 to January 2023 were selected to be included in the AOSC group,and 88 healthy volunteers during the same period were selected to be included in the control group.The patients with AOSC were divided into survival group with 36 cases and death group with 184 cases according to whether they died during hospitalization after PTCD surgical.Serum Presepsin,IAP and HMGB1 levels were detected.Multivariate Logistic regression model was used to analyze the factors affecting the prognosis of PTCD surgical treatment in patients with AOSC,the predictive value of serum Presepsin,IAP and HMGB1 levels on postoperative death in pa-tients with AOSC after PTCD surgical was analyzed by receiver operating characteristic(ROC)curve.Results:The serum Pressin,IAP,and HMGB1 levels in the AOSC group were higher than those in the control group(P＜0.05).The mortality rate during hospitalization after PTCD surgical in 220 patients with AOSC was 16.36％(36/220).Multivariate Logistic regression analysis showed that,time from onset to surgery ≥3 d,24 h postoperative bile drainage＜300 mL,elevated Presepsin,elevated IAP,and elevated HMGB1 were indepen-dent risk factors affecting the prognosis of PTCD treatment in patients with AOSC(P＜0.05).ROC curve analysis showed that,the area under the curve of serum Presepsin,IAP,and HMGB1 levels combined to predict postoperative death after PTCD surgical in patients with AOSC was 0.920,which was greater than the single indicator prediction.Conclusion:Elevated serum Presepsin,IAP,and HMGB1 levels in patients with AOSC are independent risk factors for the prognosis of PTCD treatment.The combination of serum presepsin,IAP,and HMGB1 levels has high value in predicting the prognosis of PTCD treatment in patients with AOSC.
基金项目
保定市科技计划项目(2141ZF028)
河北省医学科学研究课题计划项目(20200263)
NETL
NSTL
万方数据