| 吴云辉 甘建和△ 沈佳庆 陆中华 王艳.腹水降钙素原诊断肝硬化自发性腹膜炎的临床价值研究[J].,2015,15(30):5875-5877 |
| 腹水降钙素原诊断肝硬化自发性腹膜炎的临床价值研究 |
| The Diagnostic Significance of Ascites Procalcitonin in Liver Cirrhosis withSpontaneous Bacterial Peritonitis |
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| DOI： |
| 中文关键词: 自发性细菌性腹膜炎 腹水降钙素原 肝硬化失代偿期 |
| 英文关键词: Spontaneous bacterialial peritonitis Procalcitonin Decompensated cirrhosis |
| 基金项目:国家"十二五" 科技重大专项（2012ZX10002004-008） |
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| 中文摘要: |
| 目的：探讨腹水中降钙素原(PCT)诊断晚期肝硬化腹水并发自发性细菌性腹膜炎(SBP)的临床价值，并确定其参考值水平。方
法：选择42例肝硬化失代偿期患者为研究对象(伴SBP22 例，非SBP 20 例)，抽取其住院时、住院后24 h和48 h外周血及腹水标
本各一次，进行腹水中有核细胞数计数，并采用免疫荧光层析法同时测定和比较其血清及腹水中PCT的含量。结果：22例伴SBP
的患者血清和腹水PCT 含量均明显高于20 例不伴有SBP 的患者(P<0.01)，而伴SBP 的患者腹水PCT 含量和同时间点血清PCT
含量比较差异均无统计学意义(P＞0.05)。以入院时腹水PCT含量诊断SBP的ROC曲线的AUC为0.986，而血清PCT、腹水
PMN 计数的AUC 分别为0.942、0.868；入院后24 时腹水PCT 和血清PCT 诊断SBP 的ROC 曲线的AUC 分别为0.998 和
0.986；入院后48 时腹水PCT和血清PCT 诊断SBP的ROC 曲线的AUC 为0.986 和0.990。结论：腹水降钙素原可用于晚期肝硬
化腹水并发SBP的诊断，且较血清降钙素原和腹水中有核细胞计数具有更高的诊断价值。入院时、入院后24 h和48 h时，腹水
PCT 大于0.565 ng/mL、0.545 ng/mL和0.410 ng/mL提示患SBP可能性大。 |
| 英文摘要: |
| Objective:To discuss the clinical value of ascites procalcitonin (PCT) in the diagnosis of decompensated cirrhosis
combined with spontaneous bacterial peritonitis (SBP), and determine the reference level of ascites PCT.Methods:42 patients with liver
cirrhosis combined with ascites were enrolled in this study and divided into two groups. In group 1, 22 patients with SBP were enrolled.
20 without SBP were enrolled in group 2, and ascite sample were collected at admission, 24 hrs, and 48 hrs after admission. Serum and
ascites PCT were measurated by immunochromatographic assay simultaneously, then comparative analysis the level of their changes.Results:The serum and ascite levels of PCT in patients (n=22) with SBP were significantly higher than those without SBP(n = 20) (P<0.
01); but there is no statistical significance between the ascites and serum level of PCT in patients with SBP (P＞0.05). A more sensitive
diagnostic role of ascites PCT levels was found compared with serum PCT and ascites cell counts. The AUCs of ROC curve were: at
admission: ascites PCT 0.986, serum PCT 0.942 and ascites cell counts 0.868; 24 h after admission: ascites PCT 0.998 and serum PCT
0.986; 48 h after admission: ascites PCT 0.986 and serum PCT 0.990.Conclusion:Serum ascites PCT could be used in the diagnosis in
liver cirrhosis with SBP, and may be more sensitive than serum PCT and ascites cell counts. The SBP could be diagnosed, if the ascites
PCT levels was higher than 0.565 ng/mL (on admission), 0.545 ng/mL (24 h after admission) and 0.410 ng/mL (48 h after admission). |
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