目的    研究胆汁和血清中趋化因子受体4（CXCR4）对良、恶性胆道梗阻鉴别诊断的临床价值。方法    选择2013年2—6月哈尔滨医科大学附属第二医院收治的梗阻性黄疸病人44例，其中恶性胆道梗阻21例，良性胆道梗阻23例。分别收集病人血清和胆汁，采用酶联免疫吸附法检测CXCR4的质量浓度，并常规检测其他生化指标：血红蛋白（Hb）、总胆红素、直接胆红素、碱性磷酸酶（ALP）、丙氨酸转移酶（ALT）、天门冬氨酸转氨酶（AST）、γ-谷氨酰氨转移酶（GGT）。统计分析良、恶性胆道梗阻病人各指标的差异。结果    良、恶性胆道梗阻病人各指标比较发现，年龄、性别、血红蛋白、ALT、AST、ALP的组间差异无统计学意义（P>0.05）；而γ-GT、总胆红素、直接胆红素、血清CXCR4、胆汁CXCR4的组间差异有统计学意义（P<0.05）。多元回归分析结果显示，在纳入回归分析的5项指标中，仅胆汁CXCR4的质量浓度与胆道梗阻的良、恶性有相关关系（OR=1.05，95%CI 1.04 ~1.06，P<0.05）。结论    胆汁中CXCR4质量浓度与良、恶性胆道梗阻具有相关关系，对于其临床鉴别诊断有参考价值。

CXCR4 to clinically distinguish malignant biliary obstruction from benign biliary obstruction        LIN Ke-yu，SU Hua-wei. Department of General Surgery，the Second Affiliated Hospital of Harbin Medical University，Harbin 150086，China
Correspongding：SU Hua-wei，E-mail：Shw@medmail.com.cn
Abstract    Objective    Aim of the study was to investigate the value of bile and serum chemokine receptor-4（CXCR4) for distinguishing malignant biliary obstruction from benign biliary obstruction. Methods    Selected 44 cases of obstructive jaundice patients treat in the second affiliated hospital of Harbin medical university in February 2013 to June，including 21 cases of malignant biliary obstruction，23 cases of benign biliary obstruction. Their sera and bile were collected to detect the CXCR4 concentration by using enzyme-linked immunosorbent method, and conventional testing other biochemical indexes: hemoglobin(Hb)，total bilirubin，direct bilirubin，alkaline phosphatase(ALP)，alanine aminotransferase(ALT)，aspartate aminotransferase(AST)，γ-glutamine transferase ammonia(GGT). Do a statistical analysis of the index difference of benign and malignant biliary obstruction patients. Results    We can found that age，sex，hemoglobin，ALT，AST，ALP had no significant value between the benign and malignant biliary obstruction (P>0.05). However，r-GT，total bilirubin，serum CXCR4，bile CXCR4 had statistical significance (P<0.05). The result of multiple regression analysis show that the 5 indicators which enriched in the regression analysis，only the bile CXCR4 had relationship with benign and malignant biliary obstruction (OR=1.05，95%CI 1.04~1.06，P<0.05). Conclusion  Measurement of biliary CXCR4 may differentiate malignant biliary from benign biliary strictures，and for the clinical differential diagnosis has a reference value.