血清降钙素原在结石性急腹症中的鉴别诊断价值

Diagnostic value of serum procalcitonin in calculous acute abdomen

目的研究血清降钙素原(PCT)在不同结石性急腹症中的鉴别价值。方法选取2021年10月至2022年9月就诊于泉州市第一医院、漳州市医院门、急诊的355例结石性急腹症患者,分为单纯胆结石组(51例)、单纯泌尿系统结石组(106例)、胆结石合并胆囊炎组(159例)、泌尿系统结石合并感染组(39例),并选取同期单纯骨折、高血压、头晕、头痛等无其他合并症的100例患者作为对照组。比较各疾病组和对照组、各疾病组之间的血清PCT水平。采用受试者工作特征(ROC)曲线评估血清PCT鉴别不同结石性急腹症的诊断效能。结果对照组与单纯泌尿系统结石组的血清PCT水平比较,差异无统计学意义(P>0.05);单纯胆结石组、胆结石合并胆囊炎组、泌尿系统结石合并感染组的血清PCT水平高于对照组及单纯泌尿系统结石组,差异有统计学意义(P<0.05)。血清PCT鉴别单纯胆结石、胆结石合并胆囊炎、泌尿系统结石合并感染的曲线下面积(AUC)分别为0.709、0.909、0.955,血清PCT鉴别胆结石合并胆囊炎、泌尿系统结石合并感染的特异性、阳性预测值为97.14%、99.17%。结论在结石性急腹症中,血清PCT水平在单纯的泌尿系统结石中无诊断意义,在单纯的胆结石中诊断效能一般,主要作用在于鉴别结石性急腹症是否合并感染。

Objective To study the diagnostic value of serum procalcitonin(PCT)in calculous acute abdomen.Methods A total of 355 calculous acute abdomen patients admitted to outpatient and emergency department of Quanzhou First Hospital and Zhangzhou Hospital from October 2021 to September 2022 were selected.They were divided into single gallstone group(51 cases),simple urinary calculi group(106 cases),gallstone combined with cholecystitis group(159 cases),urinary calculi combined with infection group(39 cases),and 100 patients with simple fracture,hypertension,dizziness,headache and no other complications were selected as the control group.The serum PCT levels of each disease group and control group were compared.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum PCT in differentiating calculous acute abdomen.Results There was no significant difference in serum PCT level between control group and simple urinary calculi group(P>0.05).The serum PCT level of simple gallstone group,gallstone combined with cholecystitis,urinary calculus combined with infection group were higher than those of control group and simple urinary calculus group,the differences were statistically significant(P<0.05).The area under the curve(AUC)of serum PCT for single gallstone,gallstone combined with cholecystitis and urinary calculi combined with infection were 0.709,0.909 and 0.955,respectively.The specificity and positive predictive value of serum PCT for gallstone combined with cholecystitis and urinary calculi combined with infection were 97.14%and 99.17%.Conclusion In calculous acute abdomen,the serum PCT level has no diagnostic significance in simple urinary calculi,and the diagnostic efficacy in simple gallstones is general.The main role is to distinguish whether calculous acute abdomen is complicated with infection.