内镜逆行胰胆管造影术对胆总管结石患者血清炎症因子及肿瘤标志物表达水平的影响

Effect of Endoscopic Retrograde Cholangiopancreatography on Serum Inflammatory Factors and Tumor Markers in Patients with Common Bile Duct Stones

[目的]探讨内镜逆行胰胆管造影术(ERC P)对胆总管结石患者血清炎症因子及肿瘤标志物表达水平的影响.[方法]回顾性分析2017年1月至2018年12月本院收治的200例胆总管结石患者的临床资料,根据手术方法的不同将其分为观察组(行ERC P取石术)和对照组(行开腹取石术),每组各100例.比较两组手术相关指标,血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)及肿瘤标志物糖类抗原19-9(CA19-9)、癌胚抗原(CEA)水平.[结果]观察组手术时间、术中出血量、肛门排气时间、腹痛缓解时间、住院时间均低于对照组,差异有统计学意义(P<0.05).观察组并发症发生率为15.0%(15/100),低于对照组的5.0%(5/100),差有统计学意义(χ^2=2.275,P=0.024<0.05).对照组术后d5血清IL-1、IL-6、TNF-α水平均高于术前,且高于观察组,差异有统计学意义(P<0.05).两组患者术后d3、d5血清CA19-9水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05).[结论]内镜逆行胰胆管造影术治疗胆总管结石疗效显著、并发症少、恢复快,且能有效降低CA19-9和CEA水平.

[Objective]To investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)on serum inflammatory factors and tumor markers expression in patients with common bile duct stones.I Methods!A total of 200 patients with common bile duct stones treated in our hospital from January 2017 to December 2018 were divided into two groups,with 100 cases in each group.The observation group underwent endoscopic retrograde cholangiopancreatography,while the control group underwent routine laparotomy procedure.The indexes of surgery and levels of serum inflammatory factors(TNF-α)IL-1 and IL-6),CA19-9 and CEA expression were compared between the two groups.[Results]The operation time,intraoperative blood loss,anal exhaust time,abdominal pain relief time,and hospitalization time of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the clearance rate between the two groups(P>0.05).The incidence of complication was 7.00%(7/100)in the observation group and 15.00%(15/100)in the control group.The difference was statistically significant(P<0.05).The serum levels of IL-1,IL-6,and TNF-α in the control group at d5 post-operation were higher than those before surgery and also higher than those in the observation group;the difference was statistically significant(P<0.05).The serum levels of CA19-9 and CEA in both groups at d3 and d5 after surgery were lower than that before surgery while CA19-9 level in the observation group was lower than that in the control group.The difference was statistically significant(P<0.05).[Conclusion]Endoscopic retrograde cholangiopancreatography is effective in the treatment of common bile duct stones with less complications and faster recovery,and can effectively reduce the levels of CA19-9 and CEA.