| Objective: To evaluate the clinical value of serum procalcitonin(PCT)level on admission in judging the severity of acute cholangitis(acute cholangitis,AC),and analyse its sensitivity and specificity to enable early and rapid assessment of the severity of AC based on PCT levels at admission,and timely prescription of appropriate therapy according to the severity of the disease to improve the clinical effect of treatment,improve prognosis and reduce mortality in patients with AC.The differences between serum PCT and common inflammatory indexes such as WBC and CRP in evaluating the severity of AC were compared.Methods: Data of two hundred forty-four patients admitted to Hospitals affiliated with Yan’an University with confirmed AC between January 2017 and December 2020 were collected and analyzed,50 unacceptable cases were excluded,and 194 patients with acute biliary cholangitis(AC)were included in the study.After summarizing the clinical data of patients according to the Tokyo guidelines,96 cases were classified as mild AC,58 as moderate AC,and 40 as severe AC,and the overall clinical data and laboratory parameters of patients were subjected to statistical analysis.For laboratory results with differences in statistical analysis,operating characteristic curves(ROC-curves)of subjects were constructed,the diagnostic value of each indicator was analyzed,and,finally,a comparative analysis was performed.Results: 1.Analysis of the general clinical data of patients in the mild,moderate,and severe AC groups: statistical analysis showed that mean age was lower in the mild AC group than in the moderate and severe AC groups;mean blood pressure was lower in the severe AC group than in the mild and moderate AC groups;other general data were not statistically different and were similar between the three groups.2.Analysis of laboratory data from patients in the mild,moderate,and severe groups:statistical analysis showed that there were significant differences in TP,ALB,and PCT levels between the mild,moderate,and severe groups;as the disease progressed,TP and ALB levels decreased in patients and PCT levels tended to increase;WBC,NEUT,TBIL,DBIL,and CRP were lower in the mild group than in the moderate and severe groups,while the difference between moderate and severe AC was not statistically significant;and PT-INR was significantly higher in the severe group than in the moderate group,PLT were significantly lower in the severe AC group than in the mild and moderate AC groups,whereas PT-INR and PLT were not significantly different between the mild and moderate AC groups.3.Spearman correlation analysis was performed for parameters that were statistically different between groups: CRP,PCT,and ALB were better correlated with correlation coefficients of 0.566,0.622,and-0.533,respectively,which was at the strong correlation level.4.ROC curves were plotted for the indicators with statistical differences between groups.(1)ROC-curve analysis between mild and moderate AC groups showed that CRP and PCT had better diagnostic value than other laboratory data for mild and moderate AC:the product under the ROC curve(AUC)was 0.818 and 0.881,cut-off values were 68.58mg/L and 1.95 ng/m L,sensitivity was 84.50% and 82.80% respectively,and specificity was 87.50% and 97.90%.(2)ROC-curve analysis between the moderate and severe groups showed that among them,PT-INR and PCT had the better diagnostic value in the evaluation of moderate and severe AC with AUC of 0.779 and 0.865,cut-off values of 1.22 INR and 4.37 ng/m L,sensitivity of 67.50% and 90%,respectively,and specificity of 87.50%and 87.9%,they has good clinical value in the evaluation of moderate and severe acute cholangitis.Conclusion: Serum PCT is of good clinical value in assessing the severity of AC,and can initially judge the progress of AC.It has high sensitivity and specificity,and is superior to WBC、NEUT and CRP.It can be used to evaluate the severity of acute cholangitis early and quickly and guide the treatment. |
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