Meta-analysis of the correlation between the severity of acute cholangitis and serum markers

doi:10.3877/cma.j.issn.2095-3232.2024.02.010

Abstract

Abstract:

Objective

To analyze the correlation between the severity of acute cholangitis and serum markers, such as procalcitonin (PCT) and C-reactive protein (CRP).

Methods

Literatures related to severity of acute cholangitis in both English and Chinese were searched from PubMed, Wanfang Data and CNKI databases from database inception to December 1, 2022. The searching keywords included acute cholangitis, procalcitonin and C-reactive protein in both English and Chinese. Overall study quality was evaluated using Newcastle-Ottawa Scale. Meta-analysis was performed by Revman 5.3.5 software.

Results

After literature screening and data extraction, 1 119 patients from 10 articles were included in this study. Meta-analysis showed that there were significant differences in serum levels of PCT, CRP, WBC, Scr, ALB and INR between patients with mild and moderate acute cholangitis (WMD=-2.15, -3.28, -2.63, -0.09, 0.46, -0.05; P<0.05). There were significant differences in serum levels of PCT, CRP, Plt, Scr and INR between patients with moderate and severe acute cholangitis (WMD=-9.59, -1.66, 80.19, -0.31, -0.27; P<0.05).

Conclusions

The severity of acute cholangitis can be comprehensively evaluated according to serum markers, such as PCT, CRP and WBC. Among them, PCT is especially suitable for differential diagnosis from moderate to severe patients, which contributes to early determination of diagnosis and treatment protocols.

Key words: Cholangitis, acute, Serum markers, Procalcitonin (PCT), C-reactive protein (CRP), Meta-analysis

Rui Liu, Le Li, Jinming Chen, Xin Li. Meta-analysis of the correlation between the severity of acute cholangitis and serum markers[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(02): 176-181.

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References 20

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纳入研究	例数	年龄[岁，M（Q_R）或±s]	性别（例）		AC程度（例）			NOS评分
纳入研究	例数	年龄[岁，M（Q_R）或±s]	男	女	轻度	中度	重度	NOS评分
Shinya等^[4]，2014	110	轻度65.5（55.8～70.5）	60	50	22	63	25	8
		中度80.0（75.0～84.0）
		重度72.0（66.0～82.0）
Suwa等^[5]，2017	61	72（26～86）	41	20	12	22	27	7
Umefune等^[6]，2017	213	74（66～81）	131	82	108	76	29	9
范迪欢和邬善敏^[7]，2017	90	74（66～81）	56	34	46	32	12	5
侯晓敏^[8]，2018	89	轻度79.7±6.9	42	47	31	37	21	6
		中度80.0±5.3
		重度78.6±4.2
钱海超等^[9]，2019	113	69.52（28～90）	60	53	48	42	23	7
程红英^[10]，2021	85	50.93±12.78	47	38	42	31	12	8
邓世波^[11]，2021	194	66.96±13.75	101	93	96	58	40	5
郑丽雄^[12]，2021	56	67.5±17.5	26	30	24	15	17	6
Deng等^[13]，2022	108	64.6±18.0	56	52	43	29	36	8

纳入研究	例数	年龄[岁，M（Q_R）或±s]	性别（例）		AC程度（例）			NOS评分
纳入研究	例数	年龄[岁，M（Q_R）或±s]	男	女	轻度	中度	重度	NOS评分
Shinya等^[4]，2014	110	轻度65.5（55.8～70.5）	60	50	22	63	25	8
		中度80.0（75.0～84.0）
		重度72.0（66.0～82.0）
Suwa等^[5]，2017	61	72（26～86）	41	20	12	22	27	7
Umefune等^[6]，2017	213	74（66～81）	131	82	108	76	29	9
范迪欢和邬善敏^[7]，2017	90	74（66～81）	56	34	46	32	12	5
侯晓敏^[8]，2018	89	轻度79.7±6.9	42	47	31	37	21	6
		中度80.0±5.3
		重度78.6±4.2
钱海超等^[9]，2019	113	69.52（28～90）	60	53	48	42	23	7
程红英^[10]，2021	85	50.93±12.78	47	38	42	31	12	8
邓世波^[11]，2021	194	66.96±13.75	101	93	96	58	40	5
郑丽雄^[12]，2021	56	67.5±17.5	26	30	24	15	17	6
Deng等^[13]，2022	108	64.6±18.0	56	52	43	29	36	8

血清标志物	AC患者	WMD（95%CI）	P值	I²
PCT	轻度与中度AC	-2.15（-2.89，-1.40）	<0.001	85%
	中度与重度AC	-9.59（-12.46，-6.73）	<0.001	61%
CRP	轻度与中度AC	-3.28（-4.41，-2.15）	<0.001	84%
	中度与重度AC	-1.66（-2.18，-1.14）	<0.001	0
WBC	轻度与中度AC	-2.63（-4.23，-1.04）	0.001	89%
	中度与重度AC	-0.75（-1.77，0.26）	0.150	20%
Plt	轻度与中度AC	3.33（-9.81，16.47）	0.620	15%
	中度与重度AC	80.19（65.03，95.35）	<0.001	0
Scr	轻度与中度AC	-0.09（-0.13，-0.04）	0.001	0
	中度与重度AC	-0.31（-0.43，-0.18）	<0.001	0
ALB	轻度与中度AC	0.46（0.36，0.56）	<0.001	1%
	中度与重度AC	0.24（-0.18，0.67）	0.260	92%
INR	轻度与中度AC	-0.05（-0.07，-0.03）	<0.001	0
	中度与重度AC	-0.27（-0.34，-0.20）	<0.001	0

血清标志物	AC患者	WMD（95%CI）	P值	I²
PCT	轻度与中度AC	-2.15（-2.89，-1.40）	<0.001	85%
	中度与重度AC	-9.59（-12.46，-6.73）	<0.001	61%
CRP	轻度与中度AC	-3.28（-4.41，-2.15）	<0.001	84%
	中度与重度AC	-1.66（-2.18，-1.14）	<0.001	0
WBC	轻度与中度AC	-2.63（-4.23，-1.04）	0.001	89%
	中度与重度AC	-0.75（-1.77，0.26）	0.150	20%
Plt	轻度与中度AC	3.33（-9.81，16.47）	0.620	15%
	中度与重度AC	80.19（65.03，95.35）	<0.001	0
Scr	轻度与中度AC	-0.09（-0.13，-0.04）	0.001	0
	中度与重度AC	-0.31（-0.43，-0.18）	<0.001	0
ALB	轻度与中度AC	0.46（0.36，0.56）	<0.001	1%
	中度与重度AC	0.24（-0.18，0.67）	0.260	92%
INR	轻度与中度AC	-0.05（-0.07，-0.03）	<0.001	0
	中度与重度AC	-0.27（-0.34，-0.20）	<0.001	0

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