Background. Sepsis is a common complication of acute cholangitis (AC), which is associated with a high mortality rate. Our study is aimed at exploring the significance of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), and temperature (T) alone or combined together in early identification and curative effect monitoring of AC with or without sepsis. Methods. 65 consecutive cases with AC and 76 control cases were enrolled. They were divided into three groups: Group A (AC with sepsis), Group B (AC without sepsis), and Group C (inpatients without AC or other infections). The levels of WBC, CRP, PCT, sTREM-1, and temperature were measured dynamically. The study was carried out and reported according to STARD 2015 reporting guidelines. Results. CRP had the highest AUC to identify AC from individuals without AC or other infections (AUC 1.000, sensitivity 100.0%, specificity 100.0%, positive predictive value 100.0%, and negative predictive value 100.0%). Among various single indexes, PCT performed best (AUC 0.785, sensitivity 75.8%, specificity 72.2%, positive predictive value 68.7%, and negative predictive value 78.8%) to distinguish sepsis with AC, while different combinations of indexes did not perform better. From day 1 to day 5 of hospitalization, the levels of sTREM-1 in Group A were the highest, followed by Groups B and C (); on day 8, sTREM-1 levels in Groups A and B declined back to normal. However, other index levels among three groups still had a significant difference on day 10. Both in Groups A and B, sTREM-1 levels declined fast between day 1 and day 2 (). Conclusions. CRP is the best biomarker to suggest infection here. PCT alone is sufficient enough to diagnose sepsis with AC. sTREM-1 is the best biomarker to monitor patients’ response to antimicrobial therapy and biliary drainage.

中文翻译：

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急性胆管炎中 sTREM-1 和其他生物标志物的动态监测。

背景。脓毒症是急性胆管炎 (AC) 的常见并发症，与高死亡率相关。我们的研究旨在探索白细胞 (WBC)、C 反应蛋白 (CRP)、降钙素原 (PCT)、骨髓细胞表达的可溶性触发受体 1 (sTREM-1) 和温度 (T) 单独或结合在有或无脓毒症的 AC 的早期识别和疗效监测中。方法. 入组 65 例 AC 连续病例和 76 例对照病例。他们被分为三组：A 组（有脓毒症的 AC）、B 组（没有脓毒症的 AC）和 C 组（没有 AC 或其他感染的住院患者）。动态测量 WBC、CRP、PCT、sTREM-1 和温度的水平。该研究是根据 STARD 2015 报告指南进行和报告的。结果. CRP 从没有 AC 或其他感染的个体中识别 AC 的 AUC 最高（AUC 1.000，敏感性 100.0%，特异性 100.0%，阳性预测值 100.0%，阴性预测值 100.0%）。在各种单一指标中，PCT 在区分脓毒症与 AC 方面表现最好（AUC 0.785，敏感性 75.8%，特异性 72.2%，阳性预测值 68.7%，阴性预测值 78.8%），而不同的指标组合表现不佳。从住院第1天到第5天，A组sTREM-1水平最高，其次是B组和C组（); 第 8 天，A 组和 B 组的 sTREM-1 水平下降到正常水平。然而，三组之间的其他指标水平在第 10 天仍有显着差异。在 A 组和 B 组中，sTREM-1 水平在第 1 天和第 2 天之间快速下降（）。 结论。CRP 是提示感染的最佳生物标志物。仅 PCT 就足以诊断 AC 的败血症。sTREM-1 是监测患者对抗菌治疗和胆道引流反应的最佳生物标志物。