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Study on the Accuracy of Serum Prealbumin Level in Predicting the Prognosis of Patients with Critical Respiratory Illness
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作者 Xiang Wang Zuozhou Xie +1 位作者 Jinhong Zhao Yi Liu 《Journal of Clinical and Nursing Research》 2024年第3期89-94,共6页
Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospit... Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospital from October 2022 to September 2023 were selected and divided into an observation group and a control group after condition assessment, with 25 cases in each group. The results of cholinesterase (ChE), prealbumin (PALB), albumin (ALB), aspartate aminotransferase (AST), total protein (TP), and forced expiratory volume (FEV1)/Predicted (Pred) of the two groups were measured. Results: The ChE levels of the observation group were lower than those of the control group, while the PALB and ALB levels of the observation group were higher than those of the control group (P < 0.05). The AST, TP, and FEV1 /Pred levels of the observation group were higher than those in the control group (P < 0.05). Conclusion: Serum PALB levels can be used as the main indicator for prognosis in critically ill respiratory patients. 展开更多
关键词 Serum prealbumin Respiratory critical illness Prognostic level ACCURACY
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Serum prealbumin as an effective prognostic indicator for determining clinical status and prognosis in patients with hemorrhagic stroke 被引量:17
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作者 Shen-qi Zhang Bin Peng +3 位作者 Creed M.Stary Zhi-hong Jian Xiao-xing Xiong Qian-xue Chen 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第7期1097-1102,共6页
Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagi... Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December 2015.We collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and 14-21.The existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also recorded.Serum prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those without.Serum prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor recovery.We conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making. 展开更多
关键词 nerve regeneration prealbumin hemorrhagic stroke INFECTION gastrointestinal hemorrhage prognostic indicator PROGNOSIS neural regeneration
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Prealbumin is predictive for postoperative liver insufficiency in patients undergoing liver resection 被引量:36
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作者 Liang Huang Jing Li +3 位作者 Jian-Jun Yan Cai-Feng Liu MengChao Wu Yi-Qun Yan 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第47期7021-7025,共5页
AIM:To investigate the risk factors for postoperative liver insufficiency in patients with Child-Pugh class A liver function undergoing liver resection.METHODS:A total of 427 consecutive patients undergoing partial he... AIM:To investigate the risk factors for postoperative liver insufficiency in patients with Child-Pugh class A liver function undergoing liver resection.METHODS:A total of 427 consecutive patients undergoing partial hepatectomy from October 2007 to April 2011 at a single center(Department of Hepatic SurgeryⅠ,Eastern Hepatobiliary Surgery Hospital,Shanghai,China) were included in the study.All the patients had preoperative liver function of Child-Pugh class A and were diagnosed as having primary liver cancer by postoperative histopathology.Surgery was performed by the same team and hepatic resection was carried out by a clamp crushing method.A clamp/unclamp time of 15 min/5 min was adopted for hepatic inflow occlusion.Patients' records of demographic variables,intraoperative parameters,pathological findings and laboratory test results were reviewed.Postoperative liver insufficiency and failure were defined as prolonged hyperbilirubinemia unrelated to biliary obstruction or leak,clinically apparent ascites,prolonged coagulopathy requiring frozen fresh plasma,and/or hepatic encephalopathy.The incidence of postoperative liver insufficiency or liver failure was observed and the attributing risk factors were analyzed.A multivariate analysis was conducted to determine the independent predictive factors.RESULTS:Among the 427 patients,there were 362 males and 65 females,with a mean age of 51.1 ± 10.4 years.Most patients(86.4%) had a background of viral hepatitis and 234(54.8%) patients had liver cirrhosis.Indications for partial hepatectomy included hepatocellular carcinoma(391 patients),intrahepatic cholangiocarcinoma(31 patients) and a combination of both(5 patients).Hepatic resections of ≤ 3 and ≥ 4 liver segments were performed in 358(83.8%) and 69(16.2%) patients,respectively.Seventeen(4.0%) patients developed liver insufficiency after hepatectomy,of whom 10 patients manifested as prolonged hyperbilirubinemia unrelated to biliary obstruction or leak,6 patients had clinically apparent ascites and prolonged coagulopathy,1 patient had hepatic encephalopathy and died on day 21 after surgery.On univariate analysis,age ≥ 60 years and prealbumin < 170 mg/dL were found to be significantly correlated with postoperative liver insufficiency(P = 0.045 and P = 0.009,respectively).There was no statistical difference in postoperative liver insufficiency between patients with or without hepatitis,liver cirrhosis and esophagogastric varices.Intraoperative parameters(type of resection,inflow blood occlusion time,blood loss and blood transfusion) and laboratory test results were not associated with postoperative liver insufficiency either.Age ≥ 60 years and prealbumin < 170 mg/dL were selected on multivariate analysis,and only prealbumin < 170 mg/dL remained predictive(hazard ratio,3.192;95%CI:1.185-8.601,P = 0.022).CONCLUSION:Prealbumin serum level is a predictive factor for postoperative liver insufficiency in patients with liver function of Child-Pugh class A undergoing hepatectomy.Since prealbumin is a good marker of nutritional status,the improved nutritional status may decrease the incidence of liver insufficiency. 展开更多
关键词 prealbumin HEPATECTOMY Liver insufficiency Child-Pugh class A Primary liver cancer
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Use of the alkaline phosphatase to prealbumin ratio as an independent predictive factor for the prognosis of gastric cancer 被引量:7
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作者 Yang Li Jin-Shen Wang +2 位作者 Yun Guo Tao Zhang Le-Ping Li 《World Journal of Gastroenterology》 SCIE CAS 2020年第44期6963-6978,共16页
BACKGROUND Gastric cancer(GC)is characterized by a low 5-year survival rate.The prognosis is still not satisfactory although it has significantly improved due to developments in medicine.Thus,the identification of mor... BACKGROUND Gastric cancer(GC)is characterized by a low 5-year survival rate.The prognosis is still not satisfactory although it has significantly improved due to developments in medicine.Thus,the identification of more efficient indices for the evaluation of GC prognosis is required.We propose,for the first time,that the alkaline phosphatase(ALP)to prealbumin(PA)ratio(APR)can be used as an independent prognostic factor in GC.AIM To evaluate the prognostic value the APR in GC.METHODS According to the exclusion strategy,we collected the preoperative serologic examination results and clinical information of 409 GC patients treated in Shandong Provincial Hospital from January to December,2016.By calculating the APR,the neutrophil and lymphocyte ratio(NLR),C-reactive protein(CRP)and albumin(ALB)ratio,platelet and lymphocyte ratio,lymphocyte and monocyte ratio,and the relationship with clinical information,we verified the role of preoperative APR ratio in the prognosis of GC.In addition,we used a Cox model combined with the APR and tumor stage to demonstrate its efficacy in assessing the prognosis of GC patients.RESULTS Preoperative APR was an independent prognostic factor for GC.The median age of patients in the APR-high group was greater compared with that in the APR-low group.Patients with a higher APR had a more advanced clinical stage,higher neutrophil to lymphocyte,CRP to ALB,and platelet to lymphocyte ratios,but a lower lymphocyte to monocyte ratio(P<0.05).The APR-high group also had higher glycoprotein antigen 199 and carbohydrate antigen 125 levels than the APR-low group(P<0.05).Median overall survival and disease-free survival were significantly longer in the APR-low group than in the APR-high group.In addition,a Cox model based on the APR and tumor stage was more effective in evaluating the prognosis of patients than models based on stage alone or stage plus the NLR.CONCLUSION A higher APR is an independent and negative prognostic factor for GC.The prognosis of GC can be better evaluated using a Cox model based on the APR and stage. 展开更多
关键词 Gastric cancer PROGNOSIS Alkaline phosphatase prealbumin Evaluating efficiency
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Changes and significance of procalcitonin, C-reactive protein, peripheral leukocyte count and prealbumin in patients with severe pneumonia 被引量:1
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作者 Ping Rao 《Journal of Hainan Medical University》 2018年第7期5-7,共3页
Objective: Analyze the expression and clinical significance of procalcitonin (PCT) C-reactive protein (CRP), white blood cell count (WBCC) and prealbumin (PAA) in severe pneumonia by grouping contrast study. Methods: ... Objective: Analyze the expression and clinical significance of procalcitonin (PCT) C-reactive protein (CRP), white blood cell count (WBCC) and prealbumin (PAA) in severe pneumonia by grouping contrast study. Methods: A total of 161 cases of pneumonia were treated in a hospital from January 2017 to June 2017 as the research objects. According to the standard of severe pneumonia, 104 cases were divided into mild pneumonia group and 57 cases were divided into severe disease group. 60 healthy persons who came to our hospital for physical examination at the same time were taken as the control group.The general data of the three groups and the level of PCT, CRP, WBC, PA were compared and analyzed. Results: The age and male ratio of severe group were higher than those of control group and mild group;compared with control group, the expression of PCT, CRP, WBC in the two pneumonia group were significantly higher, while the expression of PA was significantly lower;however, the expression of PCT, CRP, WBC in severe group were significantly higher than that in mild group, while the expression of PA in severe group was significantly lower than that in mild group. PCT has higher sensitivity, specificity and accuracy among the four indexes and it has important diagnostic value. Conclusion: PCT has higher specificity, accuracy and sensitivity in the early diagnosis of severe pneumonia, and it can be used as an important index in the early diagnosis of severe pneumonia.But the combined detection of the three indexes of PCT, CRP and WBC is helpful for diagnosing severe pneumonia more accurately. 展开更多
关键词 Severe PNEUMONIA PROCALCITONIN C-reactive protein LEUKOCYTE COUNT prealbumin
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Serum Calprotectin and Prealbumin Levels among Ovarian Cancer Patients Aged 30 - 45 Years
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作者 Anastasia Petsa Vasilios Pergialiotis +5 位作者 Panagiotis Konstantopoulos Athanasia Katsichti Kyriakos Petrou Athanasios Giannopoulos Dimitrios Botsis Despina Perrea 《Open Journal of Obstetrics and Gynecology》 2017年第3期303-311,共9页
Purpose: Serum calprotectin and prealbumin have been previously linked with ovarian cancer. However, to date, their effectiveness in the diagnosis of the disease remains uncertain. The purpose of the present study is ... Purpose: Serum calprotectin and prealbumin have been previously linked with ovarian cancer. However, to date, their effectiveness in the diagnosis of the disease remains uncertain. The purpose of the present study is to determine whether serum prealbumin and calprotectin correlate with the stage and type of histologic diagnosis. Materials-Methods: In the present study, we included 80 women aged 30 - 45 years that had either primary ovarian cancer (Stages 1 and 2) with elevated levels of CA-125 (n = 40) or were healthy (n = 40). Serum calprotectin and prealbumin levels were assessed using ELISA kits. Statistical analysis was performed with SPSS v.20.0 statistical software. Results: Both plasma prealbumin and calprotectin levels were significantly different in patients with ovarian cancer compared to healthy controls. Specifically, serum prealbumin levels showed a level towards decreasing as the stage of the disease advanced (21.2 (15.5 - 30.6) in healthy controls, 12.8 (6.9 - 16) for patients with stage 1 disease and 9.9 (4.0 - 15.5) for patients with stage 2 disease p p Conclusions: Both prealbumin and calprotectin seem to be useful markers for the identification of patients suffering from ovarian cancer. 展开更多
关键词 CA-125 CALPROTECTIN OVARIAN Cancer prealbumin
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Expression differences of serum prealbumin in benign and malignant colorectal tumors
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作者 Chunni Xu Hong Chen Yan Zhou 《The Chinese-German Journal of Clinical Oncology》 CAS 2014年第6期280-282,共3页
Objective: The aim of the study was to investigate the expression differences of serum prealbumin in patients with benign and malignant colorectal tumors and its clinical significance. Methods: The concentrations of t... Objective: The aim of the study was to investigate the expression differences of serum prealbumin in patients with benign and malignant colorectal tumors and its clinical significance. Methods: The concentrations of total protein, albumin, prealbumin, hemoglobin of 113 colorectal cancer patients(cancer group) and 87 colorectal adenomas(adenoma group) were tested in Yixing Hospital Affiliated to Jiangsu University(China) during August 2013 to December 2013. Then the differences between the two groups were compared. Results: In colorectal cancer patients, the concentrations of serum prealbumin in 39/113 cases, total protein in 16/113 cases, albumin in 38/113, hemoglobin in 32/113 were lower than normal ranges. While, in colorectal adenoma patients, the concentrations of serum prealbumin in 4/87 cases, total protein in 2/87, albumin in 1/87, hemoglobin in 2/87 were below the detection limit. Comparative analysis showed that, average expression levels of serum prealbumin, albumin, total protein, hemoglobin in colorectal cancer patients were lower than those of colorectal adenoma patients, the difference was statistically significant(P < 0.05), and colorectal cancer patients were more likely to have lower levels of above indicators(P < 0.05). Conclusion: Compared to colorectal adenoma patients, patients with colorectal cancer have lower average expression levels, and were easier to have lower expression levels of serum albumin, albumin, total protein and hemoglobin, which suggest that colorectal cancer patients are more likely to have metabolic change, and clinic notable. 展开更多
关键词 colorectal cancer colorectal adenoma prealbumin
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The Correlation Analysis of NRS 2002,Patient-generated Subjective Global Assessment,Prealbumin,Transferrin,and Handgrip Strength in Nutritional Screening and Evaluation in Patients with Gastric Cancer
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作者 Gui Bin Li Xiang Hua Wu +9 位作者 Dao Lai Huang Yu Ju Xu Kui Jia Jing Zhou Li Sheng Lu Wen Xiang Zhu Feng Xi Li Yong Sheng Zhang Jing Jin Ke Ke Huang 《Journal of Nutritional Oncology》 2018年第1期34-38,共5页
Objective The present study was designed to explore the correlations between prealbumin(PA),transferrin(TF),handgrip strength and nutrition risk screening tool 2002(NRS 2002),patient-generated subjective global assess... Objective The present study was designed to explore the correlations between prealbumin(PA),transferrin(TF),handgrip strength and nutrition risk screening tool 2002(NRS 2002),patient-generated subjective global assessment(PG-SGA)in preoperative nutritional screening and evaluation in gastric cancer patients.Methods 132 cases of gastric cancer patients undergoing surgical treatment from May 2015 to January 2018 were screened and evaluated by NRS 2002 and PG-SGA within 48 h after admission,and the PA,TF and handgrip strength were measured for each patient.Results The levels of PA,TF,and handgrip strength in the nutritional risk group(NRS 2002≥3)and the malnutrition group(PG-SGA≥4)were significantly lower than that in non-nutrition risk group(NRS 2002<3)and non-malnutrition group(PG-SGA<4).The levels of PA,TF,and handgrip strength of preoperative patients were negatively correlated with NRS 2002 and PG-SGA scores(P<0.05).NRS 2002 and PG-SGA scores were positively correlated(r=0.712,P<0.01).Conclusion The preoperative nutritional risk and malnutrition rate in patients with gastric cancer are high.The combined application of PA,TF,handgrip strength,NRS 2002,and PG-SGA is more helpful for nutritional screening and assessment in gastric cancer patients. 展开更多
关键词 GASTRIC cancer NRS 2002 PG-SGA prealbumin TRANSFERRIN HANDGRIP strength
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C反应蛋白与白蛋白比值联合握力和血清前白蛋白在食管癌患者中的应用价值
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作者 彭顺仙 陶花 +2 位作者 陈晓锋 彭纪芳 蒋书娣 《实用临床医药杂志》 CAS 2024年第17期15-19,26,共6页
目的 探讨C反应蛋白与白蛋白比值(CAR)联合握力和血清前白蛋白对食管癌患者生存期及营养不良的预测价值。方法 回顾性选取212例食管癌患者作为研究对象,收集患者的基本资料和治疗前CAR、握力、血清前白蛋白检测结果,评估患者营养不良情... 目的 探讨C反应蛋白与白蛋白比值(CAR)联合握力和血清前白蛋白对食管癌患者生存期及营养不良的预测价值。方法 回顾性选取212例食管癌患者作为研究对象,收集患者的基本资料和治疗前CAR、握力、血清前白蛋白检测结果,评估患者营养不良情况并随访总生存期。采用受试者工作特征(ROC)曲线评估治疗前CAR、握力和血清前白蛋白水平对患者营养不良的预测价值,采用Kaplan-Meier生存曲线及Cox回归模型分析治疗前CAR、握力和血清前白蛋白水平对患者生存预后的预测价值。结果 ROC曲线分析结果显示,握力预测食管癌患者营养不良的曲线下面积(0.625)最大,其后依次为血清前白蛋白、CAR(分别为0.604、0.594);根据约登指数确定CAR、握力、血清前白蛋白的最佳截断值分别为0.732、23.1 kg、0.190 g/L,三者联合预测营养不良的灵敏度高达80.7%。Kaplan-Meier生存曲线分析结果显示,CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)患者的总生存期分别短于CAR<0.732、握力≥23.1 kg、血清前白蛋白水平≥0.190 g/L的患者,差异有统计学意义(P<0.01);多因素Cox回归分析结果显示,治疗前CAR增高(≥0.732)、握力降低(<23.1 kg)、血清前白蛋白水平降低(<0.190 g/L)是食管癌患者生存预后不良的独立危险因素(P<0.05)。结论 治疗前CAR、握力和血清前白蛋白是评估食管癌患者营养状态和生存预后的重要指标,三者联合检测有助于营养不良的早期诊断与及时干预,或可改善食管癌患者的生存预后。 展开更多
关键词 食管癌 C反应蛋白与白蛋白比值 握力 血清前白蛋白 营养状态 预后
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儿童急性呼吸道感染者PA、PSP、CD64、sCD14-ST的变化及其诊断价值
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作者 王俭 胡林兵 +2 位作者 罗宁 徐华英 冯小平 《海南医学》 CAS 2024年第5期694-698,共5页
目的 探讨儿童急性呼吸道感染者血前白蛋白(PA)、血清胰石蛋白(PSP)、免疫球蛋白G Fc段受体I(CD64)、可溶性白细胞分化抗原14亚型(sCD14-ST)的变化及其临床诊断价值。方法 回顾性选取2019年9月至2023年3月眉山市四所医院收治的498例儿... 目的 探讨儿童急性呼吸道感染者血前白蛋白(PA)、血清胰石蛋白(PSP)、免疫球蛋白G Fc段受体I(CD64)、可溶性白细胞分化抗原14亚型(sCD14-ST)的变化及其临床诊断价值。方法 回顾性选取2019年9月至2023年3月眉山市四所医院收治的498例儿童急性呼吸道感染患儿作为研究组,根据咽拭子细菌培养结果将其分为细菌感染组232例和非细菌感染组266例;另选取同期体检的健康儿童506例作为对照组。检测所有儿童的血清PA、PSP、外周血sCD14-ST水平、CD64指数。比较三组儿童的临床资料,同时比较研究组和对照组以及细菌感染组和非细菌感染组患儿的血清PA、PSP、外周血sCD14-ST水平、CD64指数;采用受试者工作特征曲线(ROC)分析血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测对儿童急性呼吸道感染的诊断价值。结果 研究组患儿的血清PA水平明显低于对照组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于对照组,差异均有统计学意义(P<0.05);细菌感染组患儿的血清PA水平明显低于非细菌感染组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于非细菌感染组,差异均有统计学意义(P<0.05);绘制ROC获得血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测诊断儿童急性呼吸道感染患儿的AUC分别为0.885、0.780、0.818、0.848、0.934。其中,联合诊断的AUC高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为89.20%,81.40%,诊断价值均较高。结论 儿童急性呼吸道感染者血清PA水平呈低表达,血清PSP、外周血sCD14-ST水平、CD64指数呈高表达;且细菌感染较非细菌感染的儿童急性呼吸道感染患儿血清PA水平降低,而血清PSP、外周血sCD14-ST水平和CD64指数则升高;联合检测血清PA、PSP、外周血sCD14-ST水平、CD64指数有助于诊断儿童急性呼吸道感染。 展开更多
关键词 儿童 急性呼吸道感染 前白蛋白 血清胰石蛋白 CD64 可溶性白细胞分化抗原14亚型 诊断价值
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细菌性肺炎患者血清LTB4、NLCR及CRP/PA变化及其与肺损伤程度的关系
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作者 张春红 程波 曹建 《中南医学科学杂志》 CAS 2024年第4期596-598,672,共4页
目的探讨细菌性肺炎患者血清白三烯B4(LTB4)、中性粒细胞/淋巴细胞计数比值(NLCR)及C-反应蛋白与前白蛋白(CRP/PA)比值变化及其与肺损伤程度的关系。方法回顾性选取172例细菌性肺炎患者(观察组)和同期140例健康体检者(对照组)的临床资料... 目的探讨细菌性肺炎患者血清白三烯B4(LTB4)、中性粒细胞/淋巴细胞计数比值(NLCR)及C-反应蛋白与前白蛋白(CRP/PA)比值变化及其与肺损伤程度的关系。方法回顾性选取172例细菌性肺炎患者(观察组)和同期140例健康体检者(对照组)的临床资料,根据肺损伤程度,将患者分为轻中度组和重度组。比较各组LTB4、NLCR及CRP/PA水平,分析LTB4、NLCR及CRP/PA联合评估患者肺损伤程度的价值。结果与对照组比较,观察组LTB4、NLCR及CRP/PA水平更高(P<0.05);与轻中度组比较,重度组LTB4、NLCR及CRP/PA水平更高(P<0.05);ROC结果显示,LTB4、NLCR和CRP/PA评估患者肺损伤程度的AUC为0.793、0.717、0.758,三者联合评估患者肺损伤程度的AUC为0.933,高于单项评估(P<0.05)。结论LTB4、NLCR及CRP/PA在细菌性肺炎患者中表达水平均会升高,且其均与肺损伤程度有关,其联合评估肺损伤程度的价值较高。 展开更多
关键词 细菌性肺炎 白三烯B4 中性粒细胞/淋巴细胞计数比值 C-反应蛋白/前白蛋白 肺损伤程度
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重症急性胰腺炎并发持续炎症-免疫抑制-分解代谢综合征的列线图预测模型构建与验证
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作者 郑云 涂倩倩 +1 位作者 张阿芳 张泓 《中国急救医学》 CAS CSCD 2024年第10期890-896,共7页
目的在重症急性胰腺炎(severe acute pancreatitis,SAP)是否并发持续炎症-免疫抑制-分解代谢综合征(PICS)中探讨中性粒细胞与淋巴细胞计数比值(NLR)联合纤维蛋白降解产物(FDP)与D-二聚体比值等指标的临床预测效能,并构建预测模型。方法... 目的在重症急性胰腺炎(severe acute pancreatitis,SAP)是否并发持续炎症-免疫抑制-分解代谢综合征(PICS)中探讨中性粒细胞与淋巴细胞计数比值(NLR)联合纤维蛋白降解产物(FDP)与D-二聚体比值等指标的临床预测效能,并构建预测模型。方法回顾性收集2018年5月至2023年5月安徽医科大学第一附属医院重症医学科、急诊医学科、消化内科入住的133例SAP患者的临床资料。根据PICS诊断标准将其分为SAP并发PICS组(60例)和SAP非并发PICS组(73例),对两组间NLR、FDP与D-二聚体比值及常见临床指标进行回顾性分析;比较两组患者临床特征、重症监护病房(ICU)病死率及随访1年后生存率。采用Lasso回归及多因素Logistic回归筛选出独立危险因素,构建列线图预测模型。采用受试者工作特征(ROC)曲线、校准曲线对模型进行内部验证;采用临床决策曲线分析(DCA)评估模型的临床实用性。结果与SAP非并发PICS组比较,SAP并发PICS组的改良Marshall评分、NLR、血小板计数与淋巴细胞计数比值(PLR)及FDP与D-二聚体比值均明显升高(P<0.05);SAP并发PICS组合并血流感染及腹腔感染比例明显高于SAP非并发PICS组(P<0.05);通过多因素Logistic回归分析发现,NLR、FDP与D-二聚体比值是SAP并发PICS的独立危险因素(OR分别为0.790、0.131,P均<0.05)。Lasso回归筛选的预测变量得到三因素逻辑回归模型,预测变量包括FDP/D-二聚体、NLR、C反应蛋白(CRP)/前白蛋白(OR分别为1.981、1.048、4.726,P均<0.05)。将上述因素进行模型拟合,经bootstrap内部验证列线图模型曲线下面积(AUC)为0.948(95%CI 0.909~0.980)。校准曲线接近参考曲线,且DCA显示预测模型具有良好临床实用性。结论基于NLR、FDP与D-二聚体比值、CRP/前白蛋白构建SAP患者并发PICS风险列线图预测模型具备良好区分度、校准度和实用性。在SAP早期对是否并发PICS进行评估,若并发PICS,可能提示患者预后不良。 展开更多
关键词 重症急性胰腺炎(SAP) 持续炎症-免疫抑制-分解代谢综合征(PICS) 中性粒细胞与淋巴细胞计数比值(NLR) 纤维蛋白降解产物与D-二聚体比值 C反应蛋白/前白蛋白
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急性B淋巴细胞白血病儿童乳酸脱氢酶、前白蛋白及二者比值与化疗早期疗效的相关性
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作者 宋丽丽 马平 +2 位作者 管玉洁 黄闪 刘炜 《现代临床医学》 2024年第5期326-329,共4页
目的:探讨急性B淋巴细胞白血病(B-ALL)患儿乳酸脱氢酶(LDH)、前白蛋白(PA)及二者比值(LPR)与化疗早期疗效的相关性。方法:选取2020年5月至2022年5月我院收治的B-ALL患儿126例,观察患儿初诊时(化疗前,T0)、化疗第3 d(T1)、化疗第33 d(T2)... 目的:探讨急性B淋巴细胞白血病(B-ALL)患儿乳酸脱氢酶(LDH)、前白蛋白(PA)及二者比值(LPR)与化疗早期疗效的相关性。方法:选取2020年5月至2022年5月我院收治的B-ALL患儿126例,观察患儿初诊时(化疗前,T0)、化疗第3 d(T1)、化疗第33 d(T2)的LDH、PA水平及LPR值。按照化疗第33 d微小残留病比例,将患儿分为疗效良好组(n=94)和疗效不良组(n=32),采用logistic回归分析化疗早期疗效的影响因素。结果:T1时患儿LDH及LPR低于T0,且T2低于T1(P<0.05);T2时PA高于T1(P<0.05)。临床危险度为高危、T0-WBC≥100×10~9/L、T0及T2时的LPR较高是患儿化疗早期疗效不良的危险因素(P<0.05)。结论:化疗后,B-ALL患儿LDH及LPR呈逐渐下降趋势,PA呈逐渐上升趋势,LPR与患儿化疗早期疗效具有相关性。 展开更多
关键词 急性B淋巴细胞白血病 乳酸脱氢酶 前白蛋白 乳酸脱氢酶与前白蛋白比值 化疗 早期疗效 相关性
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淋巴细胞与单核细胞比值、C反应蛋白与前白蛋白比值检测对甲型流感病毒重症感染婴幼儿的临床价值
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作者 于瑞杰 卢洋 陈杰 《中国妇幼健康研究》 2024年第4期74-78,共5页
目的 探讨淋巴细胞与单核细胞比值(LMR)、C反应蛋白与前白蛋白比值(CRP/PA)预测甲型流感病毒重症感染婴幼儿的临床价值。方法 选取2019年1月至2022年12月泰安市妇幼保健院儿内科住院的婴幼儿甲型流感病毒感染重症组(192例)、轻症组(187... 目的 探讨淋巴细胞与单核细胞比值(LMR)、C反应蛋白与前白蛋白比值(CRP/PA)预测甲型流感病毒重症感染婴幼儿的临床价值。方法 选取2019年1月至2022年12月泰安市妇幼保健院儿内科住院的婴幼儿甲型流感病毒感染重症组(192例)、轻症组(187例)及健康对照者(393例),检测其血常规、CRP及PA水平,计算中性粒细胞/淋巴细胞比值(NLR)、LMR、血小板/淋巴细胞比值(PLR)、系统免疫炎症指数(SII)、CRP/PA。采用受试者工作特征(ROC)曲线和Logistic回归分析LMR、CRP/PA对甲型流感病毒重症感染的诊断及预测价值。结果 与对照组和轻症组比较,重症组NLM、PLR、SII、CRP/PA均显著升高,LMR显著降低(分别为1.09、88.07、310.75、0.05和3.90,P<0.05)。与对照组相比,轻症组CRP/PA显著升高,LMR显著降低(分别为0.04和6.31,P<0.05)。ROC曲线显示,诊断重症感染时,CRP/PA的特异度最高,为96.1%,LMR、CRP/PA联合检测的灵敏度、ROC曲线下面积(AUC)均优于单项检测(分别为88.5%、0.941)。LMR、CRP/PA联合检测对轻症与重症感染鉴别诊断的灵敏度、特异度和AUC均优于单项检测(分别为76.4%、60.2%、0.707)。校正年龄、性别及NLM、PLR、SII后,CRP/PA的升高与LMR的降低与甲型流感病毒感染独立相关,并区分轻症和重症。结论 甲型流感病毒感染患儿CRP/PA升高与LMR降低,还有助于区分轻症和重症,可为预测感染严重程度的指标,LMR、CRP/PA联合分析对轻重症感染的鉴别诊断具有重要价值。 展开更多
关键词 淋巴细胞与单核细胞比值 C反应蛋白与前白蛋白比值 甲型流感病毒 重症感染 婴幼儿
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FT3/FT4、hs-CRP/PA、NT-proBNP水平对预测老年急性心力衰竭患者预后的价值
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作者 姜帆 周泓屹 +2 位作者 王飞跃 陈东升 吴广明 《兰州大学学报(医学版)》 2024年第7期22-27,共6页
目的 探究游离三碘甲状腺原氨酸/甲状腺素(FT3/FT4)、超敏C反应蛋白/前清蛋白(hs-CRP/PA),及氨基末端脑钠肽前体(NT-proBNP)对老年急性心力衰竭(AHF)预后不良的预测价值。方法 选取2022年3月—2023年3月首都医科大学附属北京潞河医院收... 目的 探究游离三碘甲状腺原氨酸/甲状腺素(FT3/FT4)、超敏C反应蛋白/前清蛋白(hs-CRP/PA),及氨基末端脑钠肽前体(NT-proBNP)对老年急性心力衰竭(AHF)预后不良的预测价值。方法 选取2022年3月—2023年3月首都医科大学附属北京潞河医院收治的72例老年AHF患者作为研究组,收集患者FT3/FT4、hs-CRP/PA,及NT-proBNP等临床资料及入院随访一年预后情况,根据预后情况分为预后不良组(n=23)和预后良好组(n=49);另随机抽取72例健康志愿者作为对照组,分析其临床资料及NT-proBNP、FT3/FT4、hs-CRP/PA水平差异,分析其对老年AHF的预测价值。结果 研究组患者的FT3/FT4低于对照组患者,hs-CRP/PA及NT-proBNP高于对照组患者(P<0.05);预后不良组患者FT3/FT4低于预后良好组患者,hs-CRP/PA及NT-proBNP水平高于预后良好组患者(P<0.05)。多因素Logistic回归分析结果显示NT-proBNP、FT3/FT4、hs-CRP/PA水平均为患者预后不良的影响因素(P<0.05)。受试者操作特征曲线分析结果显示,NT-proBNP、FT3/FT4、hs-CRP/PA水平预测老年AHF患者的曲线下面积分别为0.816、0.862、0.713。结论 NT-proBNP、FT3/FT4、hs-CRP/PA与老年AHF患者不良预后有关,3项指标共同使用预测患者预后效能良好。 展开更多
关键词 游离三碘甲状腺原氨酸/甲状腺素 超敏C反应蛋白/前清蛋白 氨基末端脑钠肽前体 老年急性心力衰竭 预后
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Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients
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作者 Paerhati Shayimu Maitisaidi Awula +5 位作者 Chang-Yong Wang Rexida Jiapaer Yi-Peng Pan Zhi-Min Wu Yi Chen Ze-Liang Zhao 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第10期3142-3154,共13页
BACKGROUND Anastomotic leakage(AL)is one of the severest complications after laparoscopic surgery for middle/low rectal cancer,significantly impacting patient outcomes.Identifying reliable predictive factors for AL re... BACKGROUND Anastomotic leakage(AL)is one of the severest complications after laparoscopic surgery for middle/low rectal cancer,significantly impacting patient outcomes.Identifying reliable predictive factors for AL remains a clinical challenge.Serum nutritional biomarkers have been implicated in surgical outcomes but are un-derexplored as predictive tools for AL in this setting.Our study hypothesizes that preoperative serum levels of prealbumin(PA),albumin(ALB),and transferrin(TRF),along with surgical factors,can accurately predict AL risk.AIM To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery.METHODS In the retrospective cohort study carried out at a tertiary cancer center,we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022.Preoperative serum levels of PA,ALB,and TRF were measured.We employed multivariate logistic regression to determine the independent risk factors for AL,and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis.RESULTS AL occurred in 11.96%of cases,affecting 67 out of 560 patients.Multivariate analysis identified PA,ALB,and TRF as the independent risk factor,each with an odds ratio of 2.621[95%confidence interval(CI):1.582-3.812,P=0.012],3.982(95%CI:1.927-4.887,P=0.024),and 2.109(95%CI:1.162-2.981,P=0.031),respectively.Tumor location(<7 cm from anal verge)and intraoperative bleeding≥300 mL also increased AL risk.The predictive model demonstrated an excellent accuracy,achieving an area under the receiver operating characteristic curve of 0.942,a sensitivity of 0.844,and a specificity of 0.922,demonstrating an excellent ability to discriminate.CONCLUSION Preoperative serum nutritional biomarkers,combined with surgical factors,reliably predict anastomotic leakage risk after rectal cancer surgery,highlighting their importance in preoperative assessment. 展开更多
关键词 Rectal cancer Laparoscopic operation Anastomotic leakage ALBUMIN prealbumin TRANSFERRIN
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社区获得性肺炎合并糖尿病患者的临床特征和死亡危险因素分析 被引量:1
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作者 马建芳 黄晓玲 +2 位作者 李艳华 马狄 袁开芬 《昆明医科大学学报》 CAS 2024年第2期123-130,共8页
目的 探讨社区获得性肺炎(community-acquired pneumonia,CAP)合并糖尿病(diabetes mellitus,DM)患者的临床特征和住院期间死亡的危险因素。方法 回顾性收集昆明医科大学第二附属医院2018年1月至2022年1月住院治疗的566例CAP患者资料,... 目的 探讨社区获得性肺炎(community-acquired pneumonia,CAP)合并糖尿病(diabetes mellitus,DM)患者的临床特征和住院期间死亡的危险因素。方法 回顾性收集昆明医科大学第二附属医院2018年1月至2022年1月住院治疗的566例CAP患者资料,根据患者是否合并糖尿病分为单纯CAP组(n=478),CAP合并糖尿病(CAP+DM)组(n=88),再根据患者住院期间是否死亡将CAP+DM组(n=88)分为存活组(n=69)和死亡组(n=19)。分别比较不同分组患者的临床资料和入院时的实验室化验指标,采用Cox回归分析筛选CAP+DM组患者住院期间死亡的危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估危险因素对住院期间死亡的预测价值。结果 与单纯CAP组比较,CAP+DM组患者在年龄、合并高血压、冠心病、CURB-65评分、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)、葡萄糖(glucose,GLU)、血清钾(potassium,K)、钙(calcium,Ca)、磷(phosphorus,P)、镁(magnesium,Mg)、乳酸(lactic acid,Lac),无创通气时间、入住ICU率及病死率比较上,差异有统计学意义(P <0.05);与存活组比较,死亡组患者在CURB-65评分、NLR、CRP、PCT、GIU、ALB、PA、血清铁(iron,Fe)、Ca、无创通气时间、入住ICU率比较上,差异有统计学意义(P <0.05)。Cox回归分析显示,NLR水平升高、PA水平下降是CAP合并糖尿病患者住院期间死亡的危险因素(P <0.05)。PA截断值为91 mg/L时,预测合并糖尿病的CAP患者住院期间死亡的曲线下面积(area under curve,AUC)、灵敏度和特异度分别为0.849,84.2%、81.2%。结论 CAP合并糖尿病的患者较单纯的CAP患者病情更严重,预后更差,PA对这类患者的预后具有良好的预测价值,应早期检测并积极干预,以降低患者的住院病死率。 展开更多
关键词 社区获得性肺炎 糖尿病 临床特征 病死率 前白蛋白
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NLPR、hsCRP/PA、PCT联合检测对重症急性胰腺炎的预测价值 被引量:1
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作者 王俊 胡莲 +2 位作者 刘诗 王文兵 陈澄 《西部医学》 2024年第3期427-432,共6页
目的 探讨中性粒细胞与淋巴细胞和血小板比值(NLPR)、超敏C反应蛋白(hsCRP)/前白蛋白(PA)、降钙素原(PCT)与重症急性胰腺炎(SAP)的相关性,并分析上述3个指标单独及联合检测对SAP的预测价值。方法 选取2016年2月—2022年1月宜宾市第一人... 目的 探讨中性粒细胞与淋巴细胞和血小板比值(NLPR)、超敏C反应蛋白(hsCRP)/前白蛋白(PA)、降钙素原(PCT)与重症急性胰腺炎(SAP)的相关性,并分析上述3个指标单独及联合检测对SAP的预测价值。方法 选取2016年2月—2022年1月宜宾市第一人民医院收治的急性胰腺炎(AP)患者205例,按病情严重程度分为非SAP组(n=155)和SAP组(n=50)。比较两组一般临床特征及评分,进行单因素分析,应用二元Logistic回归对NLPR、hsCRP/PA、PCT进行分析,比较联合预测因子、BISAP及Ranson评分预测价值。结果 二元Logistic回归分析发现NLPR、hsCRP/PA、PCT均为预测SAP的独立影响因素;ROC曲线结果显示,NLPR曲线下面积为0.68,最佳阈值为4.73;PCT曲线下面积为0.93,最佳阈值为0.39;hsCRP/PA曲线下面积为0.82,最佳阈值为0.44;联合预测因子曲线下面积为0.94,最佳阈值为0.13;联合预测因子的灵敏度及阴性预测率高于Ranson评分及BISAP评分。结论 NLPR、hsCRP/PA、PCT各指标在一定程度上可反映AP严重程度,可被视为早期预测SAP的指标,其联合预测因子具有较好的临床应用价值。 展开更多
关键词 急性重症胰腺炎 中性粒细胞与淋巴细胞和血小板比值 超敏C反应蛋白/前白蛋白 降钙素原 联合预测因子
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老年重症急性胰腺炎继发胰腺感染的病原菌分布及其与血清PCT、PA、FIB、HSP70和HMGB1的相关性 被引量:2
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作者 王磊 陈丽莉 +3 位作者 谢树金 张莉 孙海燕 郭主声 《海南医学》 CAS 2024年第3期358-362,共5页
目的探讨老年重症急性胰腺炎继发胰腺感染患者的病原菌分布及其与血清降钙素原(PCT)、前白蛋白(PA)、纤维蛋白原(FIB)、热休克蛋白70(HSP70)、高迁徙率族蛋白1(HMGB1)水平的相关性。方法选择2019年1月至2022年12月东莞东华医院收治的62... 目的探讨老年重症急性胰腺炎继发胰腺感染患者的病原菌分布及其与血清降钙素原(PCT)、前白蛋白(PA)、纤维蛋白原(FIB)、热休克蛋白70(HSP70)、高迁徙率族蛋白1(HMGB1)水平的相关性。方法选择2019年1月至2022年12月东莞东华医院收治的62例老年重症急性胰腺炎患者作为研究对象,根据是否继发胰腺感染分为感染组20例和未感染组42例,另选择同期健康体检的80例健康者作为对照组。记录感染组患者病原菌分布情况,比较三组受试者及感染组不同病原菌感染类型患者的血清PCT、PA、FIB、HSP70和HMGB1水平,并采用Pearson相关性分析法分析血清PCT、PA、FIB、HSP70及HMGB1水平和胰腺感染的相关性。结果感染组患者病原菌感染类型主要为细菌感染,占90.00%,其中细菌感染类型中革兰阴性菌占55.00%,革兰阳性菌占35.00%;感染组患者血清PCT、HSP70、HMGB1水平分别为(2.49±0.53)μg/L、(9.12±1.86)ng/mL、(18.33±2.61)ng/mL,明显高于未感染组的(1.56±0.41)μg/L、(5.73±1.45)ng/mL、(13.62±2.47)ng/mL和对照组的(0.23±0.06)μg/L、(0.97±0.13)ng/mL、(0.73±0.15)ng/mL,PA、FIB分别为(0.17±0.02)g/L、(2.06±0.21)g/L,明显低于未感染组的(0.23±0.04)g/L、(2.75±0.30)g/L和对照组的(0.30±0.03)g/L、(3.23±0.36)g/L,且未感染组患者的血清PCT、HSP70、HMGB1水平均高于对照组,PA、FIB均低于对照组,差异均有统计学意义(P<0.05);感染组细菌感染患者的血清PCT、HSP70、HMGB1水平分别为(2.74±0.31)μg/L、(11.06±1.43)ng/mL、(20.68±2.05)ng/mL,明显高于真菌感染患者的(2.13±0.25)μg/L、(7.93±1.05)ng/mL、(16.27±1.76)ng/mL,PA、FIB水平分别为(0.11±0.02)g/L、(1.91±0.24)g/L,明显低于真菌感染患者的(0.17±0.04)g/L、(2.58±0.34)g/L,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清PCT、HSP70、HMGB1与胰腺感染呈正相关(r=0.581、0.613、0.567,P<0.05),与PA、FIB呈负相关(r=-0.463、-0.531,P<0.05)。结论老年重症急性胰腺炎继发胰腺感染患者的病原菌类型主要为细菌感染,患者血清PCT、HSP70、HMGB1水平明显升高,PA、FIB明显降低,且与胰腺感染的发生有明显相关性,临床上应予以密切关注。 展开更多
关键词 重症急性胰腺炎 胰腺感染 降钙素原 前白蛋白 纤维蛋白原 热休克蛋白70 高迁徙率族蛋白1 相关性
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抗线粒体抗体阴性与阳性原发性胆汁性胆管炎患者临床特征比较
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作者 乔可欣 周桂琴 +4 位作者 刘亚兴 冯颖 刘尧 李斌 王宪波 《临床肝胆病杂志》 CAS 北大核心 2024年第9期1778-1784,共7页
目的对抗线粒体抗体(AMA)阴性与阳性原发性胆汁性胆管炎(PBC)患者免疫与生化指标进行分析,比较其临床特征的差异。方法收集2013年1月—2022年12月就诊于首都医科大学附属北京地坛医院的PBC患者的临床资料,分为AMA阴性组(139例,24.5%)及... 目的对抗线粒体抗体(AMA)阴性与阳性原发性胆汁性胆管炎(PBC)患者免疫与生化指标进行分析,比较其临床特征的差异。方法收集2013年1月—2022年12月就诊于首都医科大学附属北京地坛医院的PBC患者的临床资料,分为AMA阴性组(139例,24.5%)及AMA阳性组(428例,75.5%),以年龄及性别为匹配因素,匹配容差设置为0.06,进行1∶1倾向性评分匹配,分析入院时肝功能、凝血、免疫等指标,同时分析治疗6个月的肝功能等指标变化及治疗6、12个月时对于熊去氧胆酸(UDCA)的应答情况。符合正态分布的计量资料两组间比较采用成组t检验;不符合正态分布的计量资料两组间比较采用Mann-Whitney U秩和检验。计数资料两组间比较采用χ^(2)检验。结果倾向性评分匹配后AMA阴性及AMA阳性PBC患者各139例。AMA阴性组与阳性组入院时比较:AMA阴性组DBil、球蛋白(Glo)低于AMA阳性组,Alb、白蛋白/球蛋白(A/G)、前白蛋白(pre-A)、纤维蛋白原(FIB)高于AMA阳性组,差异均有统计学意义(P值均<0.05)。应用UDCA治疗6个月后,AMA阴性组与阳性组比较,Glo、pre-A水平差异均有统计学意义(P值均<0.05)。AMA阴性组与阳性组治疗6个月后pre-A较入院时均有上升,但上升程度不同,AMA阴性组上升更明显(U=41.00,P=0.015)。应用UDCA治疗6、12个月后,AMA阴性组和阳性组患者对UDCA治疗应答差异均无统计学意义(P值均>0.05)。结论在年龄及性别匹配条件下,AMA阴性PBC患者相对AMA阳性患者,肝脏炎症损伤程度轻,经UDCA治疗后炎症改善更明显,肝脏合成能力改善更明显,对于UDCA应答显现更佳趋势。 展开更多
关键词 原发性胆汁性胆管炎 抗线粒体抗体 球蛋白 前白蛋白
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