关键词: 基质细胞衍生因子-1, 巨噬细胞炎性蛋白-1α, 胆总管结石, 内镜逆行胰胆管造影取石术, 胆道感染

Abstract: Objective To explore the clinical value of serum stromal cell-derived factor-1 (SDF-1) and macrophage inflammatory protein-1α(MIP-1α) in predicting biliary tract infection after endoscopic retrograde cholangiopancreatography (ERCP) stone removal in patients with common bile duct stones. Methods From January 2022 to January 2024,100 patients with common bile duct stones who underwent ERCP stone removal surgery in Pingdingshan First People′s Hospital were collected. They were grouped into an infection group(12 cases) and a non-infection group(88 cases) based on whether biliary tract infection occurred after surgery. The general information of patients in the two groups was compared. ELISA method was used to measure the levels of serum SDF-1 and MIP-1α. Spearman method was applied to analyze the correlation between the severity of infection and serum level of SDF-1 and MIP-1α. ROC curve was applied to analyze the value of serum SDF-1 and MIP-1α to predict biliary tract infection after ERCP stone removal in patients with common bile duct stones. Results A total of 36 strains of pathogenic bacteria were detected in the biliary drainage fluid samples of the infection group, among which Gram-negative bacteria accounted for 55.56% and Gram-positive bacteria accounted for 44.44%. The infection group showed significantly higher serum levels of SDF-1 and MIP-1α (P＜0.05). As the infection worsened, SDF-1 and MIP-1α levels progressively increased (P＜0.05). The severity of biliary tract infection was significantly positively correlated with both serum SDF-1 and MIP-1α levels (P＜0.05). For predicting biliary tract infection, SDF-1 and MIP-1α exhibited AUC values of 0.761 and 0.825, sensitivities of 63.33% and 66.67%, and specificities of 83.33% and 83.33%, respectively. When combined, the predictive AUC reached 0.977, with a sensitivity of 83.33% and a specificity of 98.33%. Conclusions Serum level of SDF-1 and MIP-1α are significantly elevated in patients with common bile duct stones and biliary tract infections after ERCP stone removal surgery, showing a positive correlation with the severity of the infection. The combination of these two biomarkers demonstrates excellent predictive efficacy for postoperative infection.

Key words: stromal cell-derived factor-1, macrophage inflammatory protein-1α, common bile duct stones, endoscopic retrograde cholangiopancreatography stone removal, biliary tract infection