The Diagnostic Usefulness of Serum Total Bile Acid Concentrations in the Early Phase of Acute Pancreatitis of Varied Etiologies.
The Diagnostic Usefulness of Serum Total Bile Acid Concentrations in the Early Phase of Acute Pancreatitis of Varied Etiologies.
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DOI：
10.3390/ijms18010106
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发表时间：
2017-01-06
影响因子：
5.6
通讯作者：
Kuśnierz-Cabala B
中科院分区：
文献类型：
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作者：
Maleszka A;Dumnicka P;Matuszyk A;Pędziwiatr M;Mazur-Laskowska M;Sporek M;Ceranowicz P;Olszanecki R;Kuźniewski M;Kuśnierz-Cabala B
急性胰腺炎(AP)最常见的原因是胆道疾病、胆汁淤积和饮酒。在10%-15%的患者中，病因学确定是困难的。病原学的确定有助于实施适当的治疗。本研究的目的是评估血清总胆汁酸浓度(TBA)在急性胰腺炎的早期诊断中的作用。我们包括66名AP患者，他们在症状出现后24小时内入院。分别于AP发病后24、48、72h采用第5代全自动生化分析仪测定血清TBA。计算胆红素/总胆红素比值(B/TBA)。TBA在AP后第1天最高，随后逐渐下降。在胆道病因的患者中，血清TBA显著高于酒精和其他原因的患者。B/TBA在酒精性病因患者中显著升高。入院时，胆汁酸和B/TBA比值的临界值分别为4.70和4.22，可区分胆道和其他原因的AP，诊断准确率分别为85%和83%。TBA和B/TBA均有助于AP的早期病因诊断。
The most common causes of acute pancreatitis (AP) are biliary tract diseases with cholestasis and alcohol consumption. In 10%–15% of patients, etiology determination is difficult. Identification of the etiology allows for the implementation of adequate treatment. The aim of this study was to assess the utility of the serum concentrations of total bile acids (TBA) to diagnose AP etiology in the early phase of the disease. We included 66 patients with AP, admitted within the first 24 h from the onset of symptoms. TBA were measured in serum at 24, 48, and 72 h from the onset of AP, using an automated fifth generation assay. The bilirubin-to-TBA ratio (B/TBA) was calculated. TBA was highest on the first day of AP and decreased subsequently. In patients with biliary etiology, serum TBA was significantly higher compared to those with alcoholic and other etiologies. B/TBA was significantly higher in patients with alcoholic etiology. At admission, the cut-off values of 4.7 µmol/L for TBA and 4.22 for the B/TBA ratio allowed for a differentiation between biliary and other etiologies of AP with a diagnostic accuracy of 85 and 83%. Both TBA and B/TBA may help in the diagnosis of AP etiology in the early phase of AP.