胆汁、血清 CA199、hsCRP 水平在良恶性梗阻性黄疸疾病诊断中的临床应用价值

摘要

目的：探讨胆汁、血清CA199（Carbohydrate antigen 19‐9，CA199）、hsCRP（high sensitivity C‐reactive protein）水平在良恶性梗阻性黄疸疾病诊断中的临床价值。方法：以2012年6月－2014年12月我院普外科住院收治的恶性梗阻性黄疸疾病患者（A组，n＝51）、良性梗阻性黄疸疾病患者（B组，n＝45）、无黄疸的胆道良性疾病患者（C组，n＝60）为研究对象，分别采用电化学发光法、免疫比浊法测定三组患者的胆汁、血清CA199及hsCRP水平。结果：与血清CA199及hsCRP水平相比较，三组患者的胆汁CA199水平较血清升高，胆汁hsCRP水平较血清降低，差异有统计学意义（P＜0．05）。与三组组内血清 CA199／hsCRP比值相比较，胆汁 CA199／hsCRP比值增大，差异有统计学意义（P＜0．05）。血清 CA199／hsCRP比值与D／T比值（直接胆红素D‐BIL与总胆红素 T‐BIL的比值）在A组表现为相关关系（r＝0．925， P＜0．01），而在B组、C组均无相关性。结论：测定胆汁、血清CA199、hsCRP水平以及CA199／hsCRP比值有助于鉴别良、恶性梗阻性黄疸疾病。%Objective:To investigate the value on clinical application of the bile ,serum CA199 and hsCRP levels in pa‐tients with benign and malignant obstructive jaundice disease .Methods :The bile ,serum CA199 and hsCRP levels in pa‐tients with malignant obstructive jaundice diseases (A group ,n=51) ,Benign obstructive jaundice diseases (B group ,n=45) ,benign biliary tract disease without jaundice (C group ,n= 60) were determined through electrochemilumines‐cence and immunoturbidimetry from June 2012 to December 2014 ,respectively .Results:The bile CA199 level was high‐er than the serum level ,but bile hsCRP was lower than the serum level in the three groups (P<0 .05) .Moreover , there was statistical significance between bile CA 199/hsCRP ratio and serun CA199/hsCRP ratio within the three group (P<0 .05) .There was relationship between the serum CA199/hsCRP ratio and D/T ratio (direct bilirubin/to‐tal bilirubin) in the A group (r=0 .925 ,P<0 .01) ,but no correlation in the B and C group .Conclusion:The determina‐tion of bile ,serum CA199 ,hsCRP level and CA199/hsCRP ratio help to identify benign and malignant obstructive jaun‐dice diseases .