急性胆囊炎患者血清Visfatin、PTX3、CA19-9水平与病情预后的关系

Relationship between serum Visfatin,PTX3,CA19-9 levels and prognosis in patients with acute cholecystitis

目的探讨急性胆囊炎患者血清内脏脂肪素(Visfatin)、正五聚蛋白3(PTX3)、糖类抗原19-9(CA19-9)水平与病情预后的关系。方法选取2020年9月至2023年9月该院收治的228例急性胆囊炎患者作为研究对象,依据患者的病情严重程度将228例患者分为轻度组(n=81)、中度组(n=102)、重度组(n=45),依据患者预后情况将患者分为预后良好组(n=186)及预后不良组(n=42)。收集患者一般资料,采用酶联免疫吸附试验法检测患者血清Visfatin、PTX3水平,采用化学发光免疫分析法测定血清CA19-9水平。对急性胆囊炎患者预后影响因素进行单因素及多因素分析,以及绘制受试者工作特征曲线分析血清Visfatin、PTX3、CA19-9水平对急性胆囊炎患者预后不良的诊断价值。结果中度组、重度组血清Visfatin、PTX3、CA19-9与轻度组比较,差异有统计学意义(P<0.05);重度组血清Visfatin、PTX3、CA19-9与中度组比较,差异有统计学意义(P<0.05)。预后不良组胆囊厚度、胆囊长径、胆囊短径及血清Visfatin、PTX3、CA19-9水平与预后良好组比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示血清Visfatin、PTX3、CA19-9水平是患者预后不良的影响因素(P<0.05)。血清Visfatin、PTX3、CA19-9水平联合诊断的曲线下面积显著大于Visfatin单独诊断的曲线下面积(Z=4.577,P<0.001)和PTX3单独诊断的曲线下面积(Z=3.132,P=0.002)及CA19-9单独诊断的曲线下面积(Z=2.766,P=0.006)。结论急性胆囊炎患者血清Visfatin、PTX3、CA19-9升高,且与患者病情有关,三者联合诊断患者预后不良的价值较好。

Objective To explore the relationship between serum Visfatin,pentraxin 3(PTX3),and carbohydrate antigen 19-9(CA19-9)levels and prognosis in patients with acute cholecystitis.Methods A total of 228 patients with acute cholecystitis admitted to a hospital from September 2020 to September 2023 were selected as the study objects.According to the severity of the patients,228 patients were divided into mild group(n=81),moderate group(n=102)and severe group(n=45).The patients were divided into good prognosis group(n=186)and bad prognosis group(n=42).General data of patients were collected,serum Visfatin and PTX3 levels were detected by enzyme linked immunosorbent assay,and serum CA19-9 levels were determined by chemiluminescence immunoassay.Univariate and multivariate analysis of prognostic factors in patients with acute cholecystitis was performed,and the diagnostic value of serum Visfatin,PTX3 and CA19-9 levels in patients with acute cholecystitis was analyzed by drawing receiver operating characteristic curve.Results Serum Visfatin,PTX3 and CA19-9 in moderate and severe groups were significantly different from those in mild group(P<0.05).There were significant differences in serum Visfatin,PTX3 and CA19-9 between severe group and moderate group(P<0.05).Gallbladder thickness,long diameter and short diameter of gallbladder,serum Visfatin,PTX3 and CA19-9 levels in the poor prognosis group were significantly different from those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that serum Visfatin,PTX3 and CA19-9 levels were the influential factors for poor prognosis of patients(P<0.05).The area under the curve of serum Visfatin,PTX3 and CA19-9 combined diagnosis was significantly larger than that of Visfatin alone diagnosis(Z=4.577,P<0.001)and PTX3 alone diagnosis(Z=3.132,P=0.002)and the area under the curve of CA19-9 diagnosis alone(Z=2.766,P=0.006).Conclusion Serum Visfatin,PTX3 and CA19-9 are elevated in patients with acute cholecystitis,which is related to the patient's condition.The combination of the three is of better value in the diagnosis of poor prognosis.