关键词: 血清PTX-3, 血小板活化因子, 肝硬化, 胆总管结石, 内镜逆行胰胆管造影, 术后胰腺炎

Abstract: Objective To evaluate the clinical significance of serum penetrating-3 (PTX-3) and platelet-activating factor (PAF) in predicting post-ERCP pancreatitis (PEP) in patients with cirrhosis and choledocholithiasis. Methods A total of 120 patients with cirrhosis and choledocholithiasis who underwent ERCP at the Liver, Biliary, Pancreatic, and Spleen Diagnosis and Treatment Center of Zigong Fourth People's Hospital between April 2017 and October 2022 were enrolled in this stuydy. Patients were divided into two groups based on the occurrence of PEP within 48 hours after the procedure: the control group (n=95, no PEP) and the observation group (n=25, PEP occurred). The factors influencing the occurrence of PEP after ERCP were analyzed through both univariate and multicariate analyses. Additionally, the diagnostic efficacy of combined serum amylase, PAF, PTX-3, and TPS-2 levels in detecting PEP was evaluated. Results ① The levels of PTX-3 (13.52±0.85 ng/ml), amylase (166.80±13.52 U/L), PAF (65.32±3.52 μg/L), CRP (44.63±3.74 mg/L), and TPS-2 (189.26±4.56 μg/L) in the observation group were significantly higher than those in the control group[PTX-3 (1 .89±0.41 ng/mL),amylase (63.52±4.78 U/L), PAF(4.26±0.85 μg/L), CRP(7.20±2.06 mg/L), and TPS-2 (37.52±4.05 μg/L) ](P<0.05). ② Multivariate Logistic regression analysis identified serum PTX-3, amylase, PAF, and TPS-2 as independent predictors of PEP after ERCP (P<0.05). ③ The combined diagnostic efficacy of PTX-3, PAF, serum amylase, and TPS-2 was superior to that of any individual marker, indicating that the combined detection of these four markers has greater value in predicting the occurrence of PEP after ERCP. Conclusion The combined detection of PTX-3, PAF, TPS-2 and serum amylase has significant value in predicting the occurrence of PEP after ERCP,. This approach can facilitate the early diagnosis of PEP, making it a strategy worth promoting in clinical practive.

Key words: serum PTX-3, Platelet-activating factor, Liver cirrhosis, Choledocholithiasis, Endoscopic retrograde cholangiopancreatography, Postoperative pancreatitis