胆结石手术患者AAPR变化及对疾病转归的评估意义

Changes in AAPR levels in patients undergoing gallstone surgery and their significance in evaluating disease outcomes

目的探讨胆结石手术患者血清白蛋白(ALB)与碱性磷酸酶(ALP)比值(AAPR)变化及对疾病转归的评估意义。方法选取2021年11月至2023年12月山东大学齐鲁医院德州医院收治的126例胆结石手术患者作为研究组,根据胆结石手术疗效将研究组分为预后良好组(n=91)和预后不良组(n=35)。选取同期本院100名健康体检者作为对照组。检测所有患者ALB、ALP水平,计算AAPR。采用受试者工作特性(ROC)曲线分析ALB、ALP水平及AAPR对胆结石手术患者疾病转归的评估价值,对不同预后患者一般资料进行单因素分析,将具有统计学意义的指标,进一步纳入多因素logistic回归方程,分析胆结石手术患者疾病转归的影响因素。结果研究组患者ALB、AAPR明显低于对照组,ALP明显高于对照组,差异有统计学意义(P<0.05)。预后良好组患者ALB、AAPR明显高于预后不良组,ALP明显低于预后不良组,差异有统计学意义(P<0.05)。ALB、ALP水平评估胆结石手术患者疾病转归的AUC分别为0.746、0.827,AAPR评估的AUC为0.941。预后良好组手术途径腹腔镜手术比例明显高于预后不良组,C反应蛋白(CRP)水平明显低于预后不良组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,CRP、ALB、ALP、AAPR是胆结石手术患者疾病转归的影响因素(P<0.05)。结论AAPR在胆结石手术疾病转归不良患者中呈低表达,可作为评估胆结石手术患者疾病转归的潜在标记物。

Objective To investigate the change of serum albumin(ALB)to alkaline phosphatase(ALP)ratio(AAPR)in patients with gallstone surgery and its significance in evaluating the outcome of the disease.Methods 126 patients who underwent gallstone surgery at Dezhou Hospital of Qilu Hospital,Shandong University from November 2021 to December 2023 were selected as the study group.Based on the effectiveness of the surgery,the study group was divided into a good prognosis group(n=91)and a poor prognosis group(n=35).Additionally,100 healthy individuals from our hospital during the same period were selected as the control group.The levels of ALB and ALP in all patients were measured and the AAPR was calculated.The receiver operating characteristic(ROC)curve was used to analyze the evaluation value of ALB,ALP levels,and AAPR on the disease prognosis of patients who had undergone gallstone surgery.Univariate analysis was conducted on the general data of patients with different prognoses.Statistically significant indicators were then included in the multivariate logistic regression equation to analyze the influencing factors of disease prognosis in patients who had undergone gallstone surgery.Results ALB and AAPR in the study group were lower compared to the control group,and ALP was higher(P<0.05).ALB and AAPR in the good prognosis group were higher than those in the poor prognosis group,and ALP was lower(P<0.05).The AUC assessed by ALB and ALP were 0.746 and 0.827,respectively,and the AUC assessed by AAPR was 0.941.The proportion of laparoscopic surgery in the group with a good prognosis is significantly higher than that in the group with a poor prognosis,and the C⁃reactive protein(CRP)level was lower than that in the poor prognosis group(P<0.05).CRP,ALB,ALP,and AAPR were the influencing factors of disease outcome in patients with gallstone surgery(P<0.05).Conclusion Low expression of AAPR in patients who have undergone gallstone surgery is associated with a poor disease outcome.This suggests that AAPR could serve as a potential marker for evaluating the disease outcome in these patients.