Abstract: Objective   To observe the diagnostic value of serum carbohydrate antigen (CA) 199,  neutrophillymphocyte ratio (NLR) and plateletlymphocyte ratio (PLR) in renal function impairment of acute cholangitis. Methods  140 patients with choledocholithiasis admitted in our hospital from January 2017 to December 2019 were divided into 45 noncholangitis (common choledocholithiasis group) and 95 acute cholangitis(acute cholangitis group) according to whether they had acute cholangitis. Totally 45 health people were selected as health control group. The serum CA199,  NLR and PLR levels in the three groups were compared in each group,  related with the severity of acute cholangitis and the renal function impairment,  and their efficacy on the sensitivity and specificity in predicting renal function impairment. Results  The serum levels of CA199,  NLR and PLR in acute cholangitis group were significantly higher than those in common choledocholithiasis group and healthy control group (P<0.01),  while those in common choledocholithiasis group were significantly higher than those in healthy control group (P<0.01). The levels of CA199,  NLR and PLR in patients with acute cholangitis increased significantly with the severity of acute cholangitis
(P<0.01). The serum CA199,  NLR and PLR levels in abnormal renal function group in patients with acute cholangitis were significantly higher than those in normal renal function group (P<0.01). The serum CA199,  NLR and PLR in patients with acute cholangitis had higher sensitivity and specificity in the diagnosis of renal impairment. The combined detection of CA199,  NLR and PLR had a sensitivity of 90.0%,  a specificity of  93.8%,  and the area under the curve (AUC) of  0.933 which was significantly better than CA199 (Z=3.322,  P<0.01),  NLR(Z=3.042, P<0.01),  and PLR (Z=2.301, P<0.05),  and there was no significant difference in renal function impairment among the each makers (P>0.05). Conclusion  The serum CA199,  NLR and PLR levels are related to the severity of acute cholangitis and renal damage,  and have high sensitivity and specificity in predicting renal function impairment in acute cholangitis.

Key words: cholangitis, renal insufficiency ;diagnosis, choledocholithiasis, CA199 antigen