Suwa Yusuke, Matsuyama Ryusei, Goto Koki, Kadokura Toshiaki, Sato Mari, Mori Ryutaro, Kumamoto Takafumi, Taguri Masataka, Miyasho Taku, Endo Itaru
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Kanagawa, Japan.
Department of Biostatistics, Yokohama City University, Yokohama, Kanagawa, Japan.
J Hepatobiliary Pancreat Sci. 2017 Feb;24(2):81-88. doi: 10.1002/jhbp.420.
The incidence of biliary tract infection (BTI), especially healthcare-associated cholangitis, is increasing. However, there are few reports concerning biomarkers of acute cholangitis. We therefore performed an exhaustive investigation of several biomarkers.
We retrospectively measured 11 cytokines, six chemokines and procalcitonin (PCT), and endotoxin activity assay (EAA) values (IRB: 110512019) of 61 samples with acute cholangitis.
The 28-day mortality rate was 9.8%. The levels of most cytokines and chemokines were significantly correlated with each other. A low IL-7 level was found to predict blood culture positivity. Low IL-7 level was also found to predict disseminated intravascular coagulation. Low IL-7 levels and a high PCT level were found to be predictors of severe cholangitis. The 28-day mortality in the group of patients with an IL-7 level of ≤6.0 and a PCT level of >0.5 was 18.2%. It was significantly higher than in the other group.
The combined use of IL-7 and PCT may be useful for evaluating severe acute cholangitis; these results may suggest that severe acute cholangitis is affected by immunosuppressive changes.
胆道感染（BTI）的发病率，尤其是医疗保健相关胆管炎的发病率正在上升。然而，关于急性胆管炎生物标志物的报道很少。因此，我们对几种生物标志物进行了详尽的研究。
我们回顾性测量了61例急性胆管炎样本的11种细胞因子、6种趋化因子、降钙素原（PCT）以及内毒素活性测定（EAA）值（机构审查委员会：110512019）。
28天死亡率为9.8%。大多数细胞因子和趋化因子水平彼此显著相关。发现低白细胞介素-7（IL-7）水平可预测血培养阳性。还发现低IL-7水平可预测弥散性血管内凝血。发现低IL-7水平和高PCT水平是重症胆管炎的预测指标。IL-7水平≤6.0且PCT水平>0.5的患者组28天死亡率为18.2%。显著高于另一组。
联合使用IL-7和PCT可能有助于评估重症急性胆管炎；这些结果可能表明重症急性胆管炎受免疫抑制变化影响。
