老年经内镜逆行性胰胆管造影术后患者胆总管结石复发与IL-6及脂代谢等临床指标的相关性分析

Correlation analysis of postoperative recurrence of common bile duct stone and clinical indicators such as IL-6 and lipid metab-olism in elderly patients after ERCP

中文关键词: 老年  胆总管结石  白介素-6  脂代谢指标  胆管狭窄  经内镜逆行性胰胆管造影术  复发

英文关键词: elderly  common bile duct stones  interleukin-6  lipid metabolism indicator  biliary stricture  endoscopic retrograde cholangiopancreatography  recurrence

中文摘要:

      目的 探讨白介素-6(IL-6)及脂代谢等临床指标与老年患者行经内镜逆行性胰胆管造影术(ERCP)后胆总管结石复发的相关性.方法 回顾性选取2019年1月—2023年1月在青岛市胶州中心医院240例行ERCP的老年胆总管结石患者的临床资料,治疗后随访2年,根据胆总管结石复发情况分为复发组(n=31)和未复发组(n=209).比较2组患者治疗前IL-6、脂代谢[总胆固醇(TC)、高密度脂蛋白(HDL)、甘油三酯(TG)、低密度脂蛋白(LDL)]水平和相关临床指标值,采用Logistic回归方法分析ERCP术后老年患者胆总管结石复发的影响因素.结果 与未复发组比较,复发组患者治疗前IL-6、TC、TG、LDL水平更高,HDL水平更低,差异均有统计学意义(t=3.863、3.246、3.811、5.234,t=2.964;P＜0.05);与未复发组比较,复发组结石数量≥2个、有胆囊切除史及存在胆管狭窄的比例更高,差异均具有统计学意义(t=2.508、36.770、38.929;P＜0.05).IL-6(OR=1.070,P=0.001)、TG(OR=1.044,P=0.032)、LDL(OR=1.052,P=0.016)水平、存在胆管狭窄(OR=2.061,P=0.002)是影响ERCP术后老年患者胆总管结石复发的危险因素(P＜0.05).结论 影响ERCP术后老年患者胆总管结石复发的危险因素可能包括IL-6、TG、LDL水平和存在胆管狭窄,IL-6、TG、LDL水平较高及存在胆管狭窄的胆总管结石患者ERCP术后应定期进行复查.

英文摘要:

      Objective To investigate the relationship between clinical indicators such as interleukin-6(IL-6)and lipid metabolism indicators and the postoperative recurrence of common bile duct stones in elderly patients after endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of 240 elderly patients with common bile duct stones who un-derwent ERCP in Jiaozhou Central Hospital of Qingdao City from January 2019 to January 2023 were retrospectively selected.They were followed up for 2 years after treatment.According to the recurrence of common bile duct stones,they were divided into recurrence group(n=31)and non-recurrence group(n=209).The levels of IL-6,lipid metabolism indicators[total cholesterol(TC),high-density lipoprotein(HDL),triglycerides(TG),low-density lipoprotein(LDL)],and other relevant clinical indicators before treatment were compared between the two groups.Logistic regression analysis was used to identify in-fluencing factors for stone recurrence in elderly patients after ERCP.Results Compared with the non-recurrence group,the re-currence group had significantly higher levels of IL-6,TC,TG,and LDL,and lower level of HDL before treatment,with sta-tistically significant differences(t=3.863,3.246,3.811,5.234;t=2.964;P＜0.05).The recurrence group also had a higher proportion of patients with ≥2 stones,a history of cholecystectomy,and the presence of biliary stricture,with statisti-cally significant differences(t=2.508,36.770,38.929;P＜0.05).Elevated IL-6(OR=1.070,P=0.001),TG(OR=1.044,P=0.032),LDL(OR=1.052,P=0.016),and biliary strictures(OR=2.061,P=0.002)were identified as risk factors for stone recurrence in elderly patients after ERCP(P＜0.05).Conclusion The risk factors for recurrence of common bile duct stones in elderly patients after ERCP may include elevated IL-6,TG,LDL,and biliary stricture.Patients with higher levels of IL-6,TG,LDL,and biliary strictures should undergo regular follow-up examinations after ERCP.