血清钙水平与急性梗阻性化脓性胆管炎疾病严重程度的相关性

Correlation between serum calcium level and disease severity of acute obstructive suppurative cholangitis

目的研究血清钙水平与急性梗阻性化脓性胆管炎(AOSC)患者病情严重程度的相关性。方法回顾性选取2019年6月至2020年2月首都医科大学附属北京友谊医院急诊抢救室收治的AOSC患者共104例的临床资料, 其中合并重症脓毒症的53例患者归入A组, 单纯AOSC的51例患者归入B组, 选取同期住院的非感染性重症疾病患者共50例作为对照归入C组。比较三组患者血清钙离子、CRP、降钙素原(PCT)、D-二聚体(D-D)水平, 采用Pearson相关分析血清钙离子与CRP、PCT、D-D的相关性。结果 A组患者血清钙离子水平明显低于B组及C组, 炎症相关因子CRP、PCT、D-D水平明显高于B组及C组, 差异有统计学意义(P<0.01)。AOSC组中血清钙离子与CRP、PCT、D-D水平均呈负相关(r=-0.550、-0.479、-0.431, P<0.05)。结论 AOSC患者感染状况下机体易发生低钙血症, 且血清钙离子水平与感染炎症指标CRP、PCT、D-D呈负相关, 说明钙离子水平与患者感染的严重程度相关。临床工作中应及时发现低钙血症, 尽快对疾病的严重程度进行评估。

Objective To investigate the correlation between serum calcium level and patients with acute obstructive suppurative cholangitis(AOSC).Methods The clinical data of 104 patients with AOSC treated in the emergency room of Beijing Friendship Hospital Affiliated to Capital Medical University from June 2019 to February 2020 were retrospectively selected,of which 53 patients with severe sepsis were included in group A,51 patients with simple AOSC were included in group B,and 50 patients with non infectious severe diseases hospitalized in the same period were selected as control and included in group C.The levels of serum calcium,C-reactive protein(CRP),procalcitonin(PCT)and D-dimer(D-D)were compared in the three groups.Pearson analysis was used to analyze the correlation between serum calcium and CRP,PCT and D-D.Results The levels of serum calcium in group A were significantly lower than those in group B and group C,and the levels of inflammatory related factors CRP,PCT and D-D were significantly higher than those in group B and group C(P<0.01),with significant difference.In AOSC group,serum calcium was negatively correlated with CRP,PCT and D-D levels(r=-0.550,-0.479,-0.431,P<0.05).Conclusions Patients with AOSC are prone to hypocalcemia under infection,and the level of serum calcium is negatively correlated with infection inflammatory indexes CRP,PCT and D-D,indicating that the level of calcium is related to the severity of infection.Hypocalcemia should be found in time in clinical work,and the severity of the disease should be evaluated as soon as possible.