血清TnI联合可溶性CD163对急性胆囊炎患者病情和预后的评估价值

Evaluation value of serum troponin I combined with soluble CD163 in disease condition and prognosis of patients with acute cholecystitis

目的分析血清肌钙蛋白I(TnI)联合可溶性CD163(sCD163)对急性胆囊炎患者病情和预后的评估价值。方法回顾性收集2022年10月至2023年10月该院收治的125例急性胆囊炎患者的临床资料。根据病情的严重程度将患者分为轻度组(n=33)、中度组(n=51)和重度组(n=41)。检测患者血清中TnI、sCD163、白细胞介素(IL)-6、C反应蛋白(CRP)、总胆红素(TBIL)、ALT水平。根据患者术后3个月是否出现腹痛、消化不良、胆管炎等并发症,分成预后良好组(n=95)与预后不良组(n=30),对比患者术前各项指标。通过logistic回归分析评估患者预后情况的影响因素,并利用受试者工作特征(ROC)曲线分析TnI与sCD163在评估患者病情及预后情况中的诊断效能。结果轻度组患者的TnI、sCD163、IL-6、CRP、TBIL、ALT水平分别为(0.78±0.23)μg/L、(25.01±3.15)mg/L、(62.52±7.61)pg/mL、(32.47±4.11)mg/L、(35.65±4.61)μmol/L、(79.75±7.23)U/L,均低于中度组和重度组(P<0.05)。预后良好组的TnI为(0.99±0.37)μg/L,低于预后不良组[(1.82±0.51)μg/L,P<0.05];预后良好组的sCD163为(27.46±3.50)mg/L,低于预后不良组[(33.12±4.13)mg/L,P<0.05]。logistic分析显示,TnI、sCD163、IL-6、CRP、TBIL、ALT均是影响患者预后的重要因素;ROC曲线显示,TnI联合sCD163对病情评估的曲线下面积(AUC)为0.966(95%CI:0.937~0.995),对预后情况评估的AUC为0.948(95%CI:0.903~0.993)。结论血清TnI联合sCD163在急性胆囊炎患者病情和预后的评估中具有较高的应用价值。

Objective To analyze the evaluation value of serum troponin I(TnI)combined with soluble CD163(sCD163)in the disease condition and prognosis of the patients with acute cholecystitis.Methods The clinical data of 125 patients with acute cholecystitis admitted and treated in the hospital from October 2022 to October 2023 were retrospectively collected.The patients were divided into the mild group(n=33),moderate group(n=51)and severe group(n=41)according to the severity of disease condition.The levels of serum TnI,sCD163,interleukin(IL)-6,C reactive protein(CRP),total bilirubin(TBIL)and alanine aminotransferase(ALT)were detected.The patients were divided into the good prognosis group(n=95)and poor prognosis group(n=30)according the occurrence of complications such as abdominal pain,dyspepsia and cholangitis within postoperative 3 months.The preoperative indicators were compared between the two groups.The influencing factors of prognosis in the patients were evaluated by the logistic regress analysis.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of TnI and sCD163 in evaluating the disease condition and prognosis of the patients.Results The levels of TnI,sCD163,IL-6,CRP,TBIL and ALT in the mild group were(0.78±0.23)μg/L,(25.01±3.15)mg/L,(62.52±7.61)pg/mL,(32.47±4.11)mg/L,(35.65±4.61)μmol/L and(79.75±7.23)U/L respectively,which were lower than those in the moderate group and severe group(P<0.05).The TnI level in the good prognosis group was(0.99±0.37)μg/L,which was lower than(1.82±0.51)μg/L in the poor prognosis group(P<0.05);the sCD163 level in the good prognosis group was(27.46±3.50)mg/L,which was lower than[(33.12±4.13)mg/L]in the poor prognosis group(P<0.05).The logistic analysis showed that TnI,SCD163,IL-6,CRP,TBIL and ALT all were the important factors affecting the prognosis in the patients;the ROC curve showed the area under the curve(AUC)of TnI combined with SCD163 for evaluating the disease condition was 0.966(95%CI:0.937-0.995),which for evaluating the prognosis was 0.948(95%CI:0.903-0.993).Conclusion Serum TnI combined with sCD163 has a high application value in the assessment of the disease condition and prognosis in the patients with acute cholecystitis.