Correlation between tumor necrosis factor-α and serum cystatin C levels and the severity of acute obstructive suppurative cholangitis
Objective To explore the changes of serum tumor necrosis factor-α and serum cystatin C levels in patients with acute obstructive suppurative cholangitis(AOSC)and their relationship with the severity of the disease.Methods Clinical serum samples from 144 patients with AOSC admitted to our hospital from June 2019 to June 2023 were selected as the research objects(observation group).A total of 30 healthy people were selected as the control group.According to the severity of the disease,the patients were divided into simple AOSC subgroup(single subgroup),AOSC combined with sepsis group(AOSC+sepsis group)and AOSC combined with shock group(AOSC+shock group).The levels of serum tumor necrosis factor-α and serum cystatin C were detected on admission and 2 days after admission,and the re-ceiver operating characteristic curve was made to analyze the value of serum tumor necrosis factor-α and se-rum cystatin C levels in the diagnosis of AOSC.The comparison of quantitative data between groups was performed using one-way analysis of variance.Results The levels of serum tumor necrosis factor-α and serum cystatin C in the observation group[(58.84±25.84),(0.93±0.11)pg/ml]were significantly higher than those in the control group[(9.21±1.59),(1.53±0.26)pg/ml,t=10.600,12.310,P＜0.05].The serum tumor necrosis factor-α and serum cystatin C levels in the single subgroup[(33.97± 9.77),(1.24±0.11)pg/ml]were significantly lower than those in the AOSC+sepsis suboup[(58.56± 14.98),(1.54±0.11)pg/ml,t=9.528,7.574,P＜0.05].The serum tumor necrosis factor-α and se-rum cystatin C levels in the AOSC+shock subgroup[(84.70±18.63),(1.81±0.18)pg/ml]were high-er than those in the AOSC+sepsis subgroup[(58.56±14.98),(1.54±0.11)pg/ml,t=13.680,9.012,P＜0.05].The acute physiology and chronic health evaluation Ⅱ score in the single subgroup[(10.06±2.54)points]was significantly lower than that in the AOSC+sepsis subgroup[(15.52± 2.16)points,t=11.340,P＜0.05].The acute physiology and chronic health evaluation Ⅱ score in the AOSC+shock subgroup[(22.98±4.34)points]was higher than that in the AOSC+sepsis group[(15.52±2.16)points,t=10.650,P＜0.05].The serum tumor necrosis factor-α and serum cystatin C levels were positively correlated with the acute physiology and chronic health evaluation Ⅱ score(r=0.814,0.719,P＜0.05).The threshold value of serum tumor necrosis factor-α was 27.58 pg/ml,and the sensitivity was 80.25％,the specificity was 65.59％,and the area under the curve was 0.74.The threshold value of serum cystatin C was 1.61 pg/ml,and the sensitivity was 75.65％,the specificity was 76.98％,and the area under the curve was 0.68.The combined diagnostic sensitivity of serum tumor nec-rosis factor-α and serum cystatin C levels was 92.36％,the specificity was 85.69％,and the area under the curve was 0.89.Conclusion Serum tumor necrosis factor-α and cystatin C levels are positively corre-lated with the severity of AOSC.
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