ABSTRACT
Background: Early diagnosis and severity assessment of acute cholangitis is an important means to improve the prognosis of acute cholangitis. Aims: To investigate the clinical value of serum platelet (PLT), D-dimer (D-D) and procalcitonin (PCT) for severity assessment in patients with acute cholangitis. Methods: A total of 96 patients with acute cholangitis were enrolled, and were divided into mild group (n=40), moderate group (n=32), severe group (n=24). Levels of serum PLT, D-D and PCT were compared among the three groups. ROC curve was used to verify the predictive value for the severity assessment of acute cholangitis. Results: The serum levels of D-D and PCT increased with the increase of severity of acute cholangitis, and the differences were statistically significant (P<0.05). The serum level of PLT decreased with the increase of severity of acute cholangitis, and the difference was statistically significant (P<0.05). Correlation analysis showed that serum levels of D-D, PCT was positively correlated with severity of acute cholangitis, while serum level of PLT was negatively correlated with severity of acute cholangitis (P<0.05). When the cut-off values were 135.6×10
ABSTRACT
Background:CT portography(CTP)permits comprehensive evaluation of portal vein and its collateral pathways. It is widely used for assessment of portal hypertension in clinical practice. Aims:To assess the value of CTP in esophagogastric varices in cirrhotic patients. Methods:A retrospective cohort study was performed in 143 cirrhotic patients admitted from Jan. 2013 to Sep. 2015 at the Affiliated Hospital of Qingdao University. All patients fulfilled the inclusion criteria and underwent CTP and gastroscopy within 7 days after admission. According to the occurrence of gastrointestinal bleeding at admission,patients were allocated into two groups:bleeding group( n = 70 ) and non-bleeding group( n = 73 ). Consistency of the results of CTP and gastroscopy was analyzed by kappa coefficient;the accuracy of CTP parameters, including diameters of main portal vein(MPV),splenic vein(SPV)and left gastric vein(LGV)for prediction of variceal bleeding was evaluated by ROC curve. Results:CTP and gastroscopy had a good consistency in typing and grading of esophagogastric varices,with the kappa value of 0. 793 and 0. 775,respectively. The diameters of MPV,SPV and LGV were significantly higher in bleeding group than in non-bleeding group(P < 0. 01),and their area under the ROC curve (AUC)in predicting variceal bleeding was 0. 741,0. 627 and 0. 816,respectively. The accuracy of diameter of LGV was superior to that of MPV and SPV. With the cutoff value of 6. 1 mm,the sensitivity and specificity of diameter of LGV were 65. 71% and 84. 93% ,respectively. With the cutoff value of 16. 3 mm,the sensitivity of diameter of MPV was 75. 71% , which was higher than that of LGV and SPV. Conclusions:CTP can be used in clinical diagnosis of esophagogastric varices in cirrhotic patients,and two CTP parameters,the diameters of LGV and MPV,might be helpful for prediction of variceal bleeding.
