Predictive value of presepsin and acylcarnitines for severity and biliary drainage in acute cholangitis
作者机构：Department of Emergency MedicineBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2023年第29卷第16期
页 面：2502-2514页
核心收录：
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金：National Natural Science Foundation of China,No.81773931 Beijing Municipal Administration of Hospitals’ Youth Program,No.QML20170105 Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support "Yangfan" Project,No.ZYLX201804
主 题：Acute cholangitis Severity Biliary drainage Presepsin Acylcarnitines
摘 要：BACKGROUND Bacteremia,which is a major cause of mortality in patients with acute cholangitis,induces hyperactive immune response and mitochondrial *** is responsible for pathogen recognition by innate *** are established mitochondrial *** To clarify the early predictive value of presepsin and acylcarnitines as biomarkers of severity of acute cholangitis and the need for biliary *** Of 280 patients with acute cholangitis were included and the severity was stratified according to the Tokyo Guidelines *** presepsin and plasma acylcarnitines were tested at enrollment by chemiluminescent enzyme immunoassay and ultra-high-performance liquid chromatography-mass spectrometry,*** The concentrations of presepsin,procalcitonin,short-and medium-chain acylcarnitines increased,while long-chain acylcarnitines decreased with the severity of acute *** areas under the receiver operating characteristic curves(AUC)of presepsin for diagnosing moderate/severe and severe cholangitis(0.823 and 0.801,respectively)were greater than those of conventional *** combination of presepsin,direct bilirubin,alanine aminotransferase,temperature,and butyryl-L-carnitine showed good predictive ability for biliary drainage(AUC:0.723).Presepsin,procalcitonin,acetyl-L-carnitine,hydroxydodecenoyl-Lcarnitine,and temperature were independent predictors of bloodstream *** adjusting for severity classification,acetyl-L-carnitine was the only acylcarnitine independently associated with 28-d mortality(hazard ratio 14.396;P0.001)(AUC:0.880).Presepsin concentration showed positive correlation with direct bilirubin or *** Presepsin could serve as a specific biomarker to predict the severity of acute cholangitis and need for biliary ***-L-carnitine is a potential prognostic factor for patients with acute *** immune response was associated with mitoc
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