血清UMOD、MFG-E8和CA199对急性胆管炎合并肾损伤的诊断价值

Diagnostic value of serum UMOD,MFG-E8 and CA199 in acute cholangitis with renal impairment

目的观察血清尿调节素(UMOD)、乳脂球表皮生长因子8(MFG-E8)和糖类抗原(CA)199对急性胆管炎合并肾损伤的诊断价值。方法选取2018年1月至2020年1月在该院就诊且诊断为胆总管结石引起的急性胆管炎患者106例作为急性胆管炎组。选择同期在该院就诊的单纯胆总管结石患者75例作为胆总管结石组(75例)和在该院行体检的健康者45例作为健康对照组。观察各组血清UMOD、MFG-E8和CA199水平变化和急性胆管炎患者血清UMOD、MFG-E8和CA199水平与急性胆管炎严重程度的关系,以及其对急性胆管炎合并肾损伤的诊断效能等。结果急性胆管炎组血清UMOD和MFG-E8水平明显低于胆总管结石组和健康对照组,差异有统计学意义(P<0.05);急性胆管炎组血清CA199水平明显高于胆总管结石组和健康对照组,差异有统计学意义(P<0.05)。血清UMOD和MFG-E8水平随着急性胆管炎严重程度的升高而降低(P<0.05),而血清CA199水平随着急性胆管炎严重程度的升高而升高(P<0.05)。急性胆管炎患者血清UMOD(r=-0.6238,P<0.05)、MFG-E8(r=-0.8150,P<0.05)与CA199呈负相关,而血清UMOD与MFG-E8水平呈正相关(r=0.7680,P<0.05)。结论血清UMOD、MFG-E8和CA199水平与急性胆管炎的严重程度相关,3项指标联合检测对急性胆管炎合并肾损伤具有较高的诊断效能。

Objective To observe the diagnositc value of serum uromodulin(UMOD),milk fat globule epidermal growth factor 8(MFG-E8)and carbohydrate antigen(CA)199 in acute cholangitis with renal impairment.Methods A total of 106 patients with acute cholangitis caused by choledocholithiasis diagnosed in a hospital from January 2018 to January 2020 were selected as the acute cholangitis group.Seventy-five patients with simple choledocholithiasis admitted to a hospital during the same period were selected as the choledocholithiasis group(75 cases)and 45 healthy subjects undergoing physical examination in a hospital as the healthy control group.To observe the changes of serum UMOD,MFG-E8 and CA199 in each group and the relationship between serum UMOD,MFG-E8 and CA199 in patients with acute cholangitis and the severity of acute cholangitis,and the diagnostic efficacy of its indexes in acute cholangitis with renal impairment and so on.Results The levels of serum UMOD and MFG-E8 in acute cholangitis group were significantly lower than those in choledocholithiasis group and healthy control group,with statistical significance(P<0.05).The level of serum CA199 in acute cholangitis group was significantly higher than that in choledocholithiasis group and healthy control group,and the difference was statistically significant(P<0.05).Serum UMOD and MFG-E8 levels decreased with the increase of acute cholangitis severity(P<0.05),while serum CA199 levels increased with the increase of acute cholangitis severity(P<0.05).Serum UMOD(r=-0.6238,P<0.05)and MFG-E8(r=-0.8150,P<0.05)were negatively correlated with CA199 in patients with acute cholangitis,while serum UMOD was positively correlated with MFG-E8(r=0.7680,P<0.05).Conclusion Serum UMOD,MFG-E8 and CA199 levels are correlated with the severity of acute cholangitis,and their combined detection of the three indexes has a high diagnostic efficacy for acute cholangitis with renal impairment.