血浆与胆道引流液中降钙素原及脂联素水平检测在胆石症患者术后的临床应用

Clinical application of detection of PCT,ADP levels in plasma and biliary drainage of patients with cholelithiasis after surgery

目的：探讨降钙素原（ PCT）、脂联素（ ADP）水平的检测在胆道结石术后留置导管引流患者血浆以及胆道引流液中的临床应用。方法将胆道结石术后留置引流导管的122例患者分为三组，A组（对照组）不进行PCT、ADP水平检测，B组于术后第1、7天取胆道引流液行PCT、ADP水平检测，C组术后第1、7天取血浆行PCT、ADP水平检测。结果术后第7天B组胆道引流液中PCT水平高于C组血清PCT水平（ P﹤0.05）；B组术后第7天胆道引流液中PCT水平高于其术后第1天胆道引流液中PCT水平（ P﹤0.01），C组术后第7天血清PCT水平高于其术后第1天血清PCT水平（P﹤0.01）。术后第7天B组胆道引流液中ADP水平低于C组血清ADP水平（P﹤0.05）；B组术后第7天胆道引流液中ADP水平低于其术后第1天胆道引流液中ADP水平（P﹤0.01）。A组术后出现导管相关血行感染（CRBSI）者多于B组（P﹤0.01）。结论血浆或胆道引流液中PCT、ADP水平的检测能更早期发现CRBSI，PCT、ADP在胆道引流液中的改变比外周血中的改变更显著。

Objective To investigate the clinical application of detection of procalcitonin （ PCT）,adiponectin（ ADP）levels in plasma and bile drainage of patients with cholelithiasis after surgery indwelling catheter drainage. Methods One hundred and twenty-two patients with cholelithiasis after surgery indwelling catheter drainage were divided into three groups. The patients in group A（ control group）did not need to have detection of their PCT,ADP levels. The biliary drainage liquid were extrac-ted to detect PCT,ADP levels on the 1st and 7th day after surgery in group B,the plasma were extracted to detect PCT,ADP levels at the same time in group C. Results The levels of PCT in biliary drainage of patients in groups B were higher than those in plasma in group C on the 1 st and 7 th day after surgery （ P﹤0. 05 ）. The levels of PCT in biliary drainage of patients on the 7 th day after surgery were higher than those in the first day after surgery in group B（ P﹤0. 01 ）. Similarly the levels of PCT in plasma of patients on the 7 th day after surgery were higher than those on the first day after surgery in group C（ P﹤0. 01 ）. The levels of ADP in biliary drainage of patients in group B were lower than those in plasma in group C on the 1 st and 7 th day after surgery（ P﹤0. 05 ）. And the ADP levels in biliary drainage of pa-tients on the 7 th day after surgery were lower than those on the first day after surgery in groups B（ P﹤0. 01）. The proportion of patients with catheter-related bloodstream infection（ CRBSI）in group A was higher than that in group B after surgery（ P﹤0. 01 ）. Conclusions The detection of PCT and ADP lev-els in biliary drainage or plasma of patients can find CRBSI earlier. The change of PCT,ADP levels in biliary drainage is more significant than that in Plasma.