血清可溶性CD163水平与急性化脓性胆囊炎病情严重程度的关系研究

Study on the relationship between the level of serum soluble CD163 and the severity of acute suppurative cholecystitis

目的分析血清可溶性血红蛋白清道夫受体(sCD163)水平与急性化脓性胆囊炎病情严重程度的关系。方法选取2017年6月—2019年9月滁州市第一人民医院急诊外科诊治急性化脓性胆囊炎患者150例作为研究组,依据病情严重程度分为轻度亚组47例,中度亚组55例,重度亚组48例;同期选取健康体检者100例为健康对照组。比较2组血清sCD163、炎性因子和高迁移率族蛋白B1(HMGB1)水平。利用Pearson分析血清sCD163水平与炎性指标间的相关性,利用多因素Logistic回归分析影响急性化脓性胆囊炎发生的危险因素。结果研究组白细胞、中性粒细胞、血红蛋白、血清总胆红素水平均高于健康对照组(t/P=5.782/0.000、2.501/0.013、5.050/0.000、6.854/0.000),血清sCD163、CRP、IL-6、IL-1β、TNF-α、HMGB1水平均高于健康对照组,且随着病情加重,各个指标水平均呈上升趋势,差异均有统计学意义(F/P=97.987/0.000、117.866/0.000、30.530/0.000、25.328/0.000、22.716/0.000、77.919/0.000);血清sCD163水平与CRP、IL-6、IL-1β、TNF-α、HMGB1均呈正相关(r/P=0.367/0.001、0.352/0.001、0.371/0.001、0.413/0.000、0.457/0.000),多因素Logistic回归分析显示,sCD163(OR=1.534,95%CI 1.116~2.107)、CRP(OR=1.367,95%CI 1.013~1.845)、IL-6(OR=1.281,95%CI 1.024~1.602)、IL-1β(OR=1.143,95%CI 1.004~1.311)、TNF-α(OR=1.216,95%CI 1.069~1.627)和HMGB1(OR=1.382,95%CI 1.131~1.688)均为急性化脓性胆囊炎的危险因素。结论急性化脓性胆囊炎患者血清sCD163水平升高,且随着病情加重而上升,可作为判定急性化脓性胆囊炎病情严重程度的指标。

Objective To analyze the relationship between serum soluble hemoglobin scavenger receptor(sCD163)and the severity of acute suppurative cholecystitis.Methods From June 2017 to September 2019,150 patients with acute suppurative cholecystitis were selected as the study group.According to the severity of the disease,47 cases were divided into mild sub group,55 cases in moderate sub group and 48 cases in severe sub group.At the same time,100 healthy people were selected as the control group.The serum levels of sCD163,inflammatory factors and HMGB1 were compared between the two groups.Pearson was used to analyze the correlation between serum sCD163 level and inflammatory index.Multivariate logistic regression was used to analyze the risk factors of acute suppurative cholecystitis.Results The levels of white blood cells,neutrophils,hemoglobin,and serum total bilirubin in the study group were higher than those in the healthy control group(t/P=5.782/0.000,2.501/0.013,5.050/0.000,6.854/0.000),serum sCD163,CRP,The levels of IL-6,IL-1β,TNF-α,and HMGB1 were higher than those of the healthy control group,and as the disease worsened,the levels of various indicators showed an upward trend,and the differences were statistically significant(F/P=97.987/0.000,117.866/0.000,30.530/0.000,25.328/0.000,22.716/0.000,77.919/0.000);serum sCD163 levels were positively correlated with CRP,IL-6,IL-1β,TNF-α,HMGB1(r/P=0.367/0.001,0.352/0.001,0.371/0.001,0.413/0.000,0.457/0.000).Multivariate logistic regression analysis showed that sCD163(OR=1.534,95%CI 1.116 to 2.107),CRP(OR=1.367,95%CI 1.013to 1.845),IL-6(OR=1.281,95%CI 1.024 to 1.602),IL-1β(OR=1.143,95%CI 1.004 to 1.311),TNF-α(OR=1.216,95%CI 1.069 to 1.627)and HMGB1(OR=1.382,95%CI 1.131 to 1.688)are all acute suppurative cholecystitis Risk factors.Conclusion The level of serum scd163 in patients with acute suppurative cholecystitis increased with the aggravation of the disease,which can be used as an index to determine the severity of acute suppurative cholecystitis.