Li ZhaoXin, Qi HongGuang, Zhang Long, Huang YunFei
Clin Lab. 2025 Jan 1;71(1). doi: 10.7754/Clin.Lab.2024.240812.
The aim of this study was to explore the clinical value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in evaluating complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct (CBD) stones.
Patients who were diagnosed with CBD stones and underwent ERCP from December 2021 to December 2023 were selected as the study subjects. According to whether postoperative complications occurred, they were divided into complication group (n = 28) and non-complication group (n = 132). The general clinical data, biochemical indexes, serum PCT, and CRP levels before ERCP and 4 hours and 24 hours after ERCP were compared. The changes of serum PCT and CRP levels in patients with different types of complications at 4 hours and 24 hours after ERCP were analyzed. The value of serum PCT, CRP levels, and combined indicators in distinguishing postoperative complications was analyzed.
The proportion of previous pancreatitis and complications (hypertension and diabetes) in the complication group was higher than that in the non-complication group. Serum PCT and CRP levels of patients in the complication group were significantly higher than those in the non-complication group at 24 hours after ERCP (p < 0.001). Stratified according to the main types of complications, CRP level of patients with postoperative pancreatitis continued to increase at 4 hours and 24 hours after ERCP, while serum PCT increased only after 24 hours. When serum PCT and CRP levels were higher than 2.61 μg/mL and 68.18 mg/mL, respectively, at 24 hours after ERCP, the patients with postoperative complications could be well distinguished. The combination of the two indicators had a higher value in distinguishing patients with postoperative complications than the serum indicators alone.
The increase of serum PCT and CRP levels after ERCP is related to the complications after ERCP in patients with CBD stones. For patients with a high risk of complications after ERCP, the possibility of complications occurring can be evaluated by combined examination of serum PCT and CRP levels, and prevention and treatment measures can be taken as soon as possible.
本研究旨在探讨血清降钙素原（PCT）和C反应蛋白（CRP）水平在评估胆总管结石患者内镜逆行胰胆管造影术（ERCP）后并发症中的临床价值。
选取2021年12月至2023年12月诊断为胆总管结石并接受ERCP的患者作为研究对象。根据术后是否发生并发症，将其分为并发症组（n = 28）和无并发症组（n = 132）。比较两组患者的一般临床资料、生化指标、ERCP术前及术后4小时、24小时的血清PCT和CRP水平。分析不同类型并发症患者ERCP术后4小时和24小时血清PCT和CRP水平的变化。分析血清PCT、CRP水平及联合指标在鉴别术后并发症中的价值。
并发症组既往胰腺炎及并发症（高血压、糖尿病）的比例高于无并发症组。ERCP术后24小时，并发症组患者的血清PCT和CRP水平显著高于无并发症组（p < 0.001）。按主要并发症类型分层，术后胰腺炎患者的CRP水平在ERCP术后4小时和24小时持续升高，而血清PCT仅在术后24小时升高。ERCP术后24小时，当血清PCT和CRP水平分别高于2.61 μg/mL和68.18 mg/mL时，可较好地区分术后并发症患者。两项指标联合在鉴别术后并发症患者方面比单独的血清指标具有更高的价值。
ERCP术后血清PCT和CRP水平升高与胆总管结石患者ERCP术后并发症有关。对于ERCP术后并发症高危患者，可通过联合检测血清PCT和CRP水平评估并发症发生的可能性，并尽早采取防治措施。
