炎症指数可以预测普通胆道结石的自发通过吗?
İrfan Küçük1, Yusuf Yazgan1, Ersin Tural2
1Department of Gastroenterology, University of Health Sciences, İstanbul, Turkey.
Scottish medical journal
|September 11, 2023
概括
炎症指数如C-反应蛋白与白蛋白比率 (CAR) 和CRP-淋巴细胞比率 (CLR) 可能有助于在ERCP之前预测常见的胆道结石 (CBDS). 这些炎症指数的低值可能表明自发CBDS迁移.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在内镜逆行胆道瘤学 (ERCP) 之前,由于潜在的自发清除,对常见胆道结石 (CBDS) 的准确诊断至关重要.
- 区分需要干预的CBDS和可能自发清除的CBDS对于最佳的患者管理至关重要.
研究的目的:
- 评估炎症指数的诊断实用性,包括中性粒细胞-淋巴细胞比率 (NLR),C反应蛋白 (CRP) 与白蛋白比率 (CAR) 和CRP-淋巴细胞比率 (CLR),用于预测ERCP之前常见胆道结石 (CBDS) 的分泌.
- 为了确定这些炎症标志物是否可以帮助识别那些可能经历自发石头通道的CBDS患者.
主要方法:
- 对96名CBDS患者的回顾性分析证实了磁共振胆血管细胞造影 (MRCP) 和ERCP (A组) 以及36名CBDS患者的MRCP但不是ERCP (B组).
- 计算各种炎症指数 (IIs),包括NLR,CAR和CLR在呈现和ERCP之前.
- 统计分析以比较不同组的II并评估其在ERCP中检测CBDS的诊断性能.
主要成果:
- 在ERCP之前的B组 (ERCP中没有CBDS) 相比,在A组 (ERCP中存在CBDS) 观察到更高的CAR和CLR值 (分别p=0.027和p=0.029).
- 较高的CRP,CAR和CLR值显示了在ERCP中检测石头的显著诊断准确性 (AUC>0.62).
- 在MRCP上,石头大于3.25毫米的石头大小与ERCP期间石头检测的可能性显著增加有关.
结论:
- 较低的C-反应蛋白 (CRP),C-反应蛋白与白蛋白比率 (CAR) 和CRP-淋巴细胞比率 (CLR) 的值可能与常见胆道结石 (CBDS) 的自发迁移有关.
- 这些炎症指数显示出作为预测CBDS自发清除的非侵入性标记物的潜力,可能指导有关ERCP的决策.
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