血清淀粉样蛋白A与白介素-6在急性胆管炎病情评估中的价值

赵尚飞.血清淀粉样蛋白A与白介素-6在急性胆管炎病情评估中的价值[J].内科急危重症杂志,2026,32(1):22-25

DOI：10.11768/nkjwzzzz20260105

中文关键词: 血清淀粉样蛋白A 白介素-6 降钙素原 C反应蛋白急性胆管炎

英文关键词:

基金项目:

作者	单位	E-mail
赵尚飞		mingquansong@163.com

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中文摘要:

摘要目的：探讨血清淀粉样蛋白A（SAA）、白介素-6（IL-6）在评估急性胆管炎严重程度中的临床价值。方法：选取130例急性胆管炎患者，根据2021年版急性胆道系统感染的诊断和治疗指南分级标准，分为轻度组52例，中度组48例，重度组30例。比较治疗前、治疗后4 d、出院前3组患者血清SAA、IL-6、降钙素原（PCT）及C反应蛋白（CRP）水平，采用受试者工作特征（ROC）曲线比较各指标对急诊胆管炎严重程度的预测价值。结果：治疗前重度组患者的血SAA、IL-6、PCT及CRP水平高于轻度组、中度组，中度组高于低度组（P均＜0.05）。治疗后4 d、出院前3组患者的血SAA、IL-6、PCT及CRP水平均明显下降（P均＜0.05）。相关性分析显示，SAA、IL-6水平与急性胆管炎病情分级均呈正相关(r=0.776、0.800，P均＜0.05)。ROC曲线分析显示，SAA、IL-6、PCT及CRP预测中度胆管炎的ROC曲线下面积分别为0.877、0.879、0.799、0.776, 最佳截断值分别为225.5 mg/L、113.81 pg/mL、3.6 ng/mL、99.18 mg/L；以上4项指标预测重度胆管炎的ROC曲线下面积分别为0.916、0.938、0.830、0.787, 最佳截断值分别为296.3 mg/L、216.34 pg/mL、4.17 ng/mL、120.83 mg/L。SAA联合IL-6预测中度、重度胆管炎的ROC曲线下面积分别为0.937、0.974，预测效能优于各独立指标（P均＜0.05）。结论：血清SAA、IL-6在评估急性胆管炎严重程度中具有良好的价值，联合检测的预测价值更高。

英文摘要:

Abstract Objective: To investigate the clinical value of serum amyloid A (SAA) and interleukin-6 (IL-6) in assessing the severity of acute cholangitis.Methods: A total of 130 patients with acute cholangitis were enrolled and classified accordingto the 2021 guidelines for the diagnosis and management of acute cholangitis: 52 cases in the mild group, 48 in the moderate group, and 30 in the severe group. The levels of SAA, IL-6, procalcitonin (PCT), and C-reactive protein (CRP) were compared among the groups before treatment, after 4 days of treatment, and before discharge. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of each indicator for the severity of acute cholangitis. Results: Before treatment, the levels of SAA, IL-6, PCT, and CRP in the severe group were higher than those in the moderate and mild groups, and the levels in the moderate group were higher than those in the mild group (all P< 0.05). After 4 days of treatment and before discharge, the levels of SAA, IL-6, PCT, and CRP decreased significantly in all three groups (all P< 0.05). Correlation analysis showed that SAA and IL-6 levels were positively correlated with the severity grading of acute cholangitis (r= 0.776 and 0.800, respectively; both P< 0.05). The ROC curve analysis revealed that the areas underthe ROC curve (AUC) of SAA, IL-6, PCT, and CRP for predicting moderate cholangitis were 0.877, 0.879, 0.799, and 0.776, with optimal cut-off values of 225.5 mg/L, 113.81 pg/mL, 3.6 ng/mL, and 99.18 mg/L, respectively. For predicting severe cholangitis, the AUCs were 0.916, 0.938, 0.830, and 0.787, with optimal cut-off values of 296.3 mg/L, 216.34 pg/mL, 4.17 ng/mL, and 120.83 mg/L, respectively. The combined detection of SAA and IL-6 yielded AUCs of 0.937and 0.974 for moderate and severe acute cholangitis, respectively, demonstrating superior predictive performance compared to each indicator alone (both P< 0.05). Conclusion: Serum SAA and IL-6 are valuable markers for assessing the severity of acute cholangitis, and their combined detection provides even higher predictive value.