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预测HIV感染患者的胆结石胰腺炎
F Anderson1, T E Madiba2, S R Thomson3
1Specialist Surgical Services, Inkosi Albert Luthuli Central Hospital, South Africa. †Died.
概括
在患有急性胰腺炎的HIV阳性患者中,某些异常的实验室结果可以准确预测非胆结石原因,减少不必要的手术. 这些标记物的缺失是非胆结石性胰腺炎的强有力的指标,特别是在HIV+患者中.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染,低CD4计数和抗逆转录病毒疗法可以导致胆固醇和高氨酸酶.
- 这些情况可能会影响胆结石相关急性胰腺炎的生化预测指标的准确性.
研究的目的:
- 为了比较胆结石胰腺炎 (GSP) 和胆胆病在艾滋病毒阳性 (HIV+ve) 与艾滋病毒阴性 (HIV-ve) 患者中的生化标志物的预测准确性.
- 评估胆固醇酶,高氨酸酶和胆道直径在诊断GSP中的实用性.
主要方法:
- 对216名被诊断患有急性胰腺炎的患者进行前性观察性研究.
- 超声波用于诊断胆囊质病和胆道直径.
- 胆病和胆炎是根据特定标准定义的;ERCP适用于胆病,胆炎或胆管直径大于1厘米.
主要成果:
- 62%的患者有GSP;24人是HIV+感染者.
- 艾滋病毒+ve患者的胆固醇和ERCP的比率更高.
- 与HIV-ve患者 (84-84.6%) 相比,艾滋病病毒+ve患者 (92-96.7%) 的阿拉宁氨基转移酶 (ALT),马谷氨基转移酶 (GGT) 和胆固醇酶的负预测值更高.
- 在接受ERCP的25%的HIV+ve和8%的HIV-ve患者中发现了胆管结石.
结论:
- 没有分析的异常参数有效预测非胆结石性胰腺炎,特别是在HIV+ve个体.
- 像MRCP或EUS这样的ERCP前成像可以减少非治疗性的ERCP.
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