慢乙肝肝硬化伴自发性腹膜炎患者血PCT、CRP、WBC变化及诊断价值

发布时间：2018-01-25 08:25

本文关键词： 肝硬化自发性腹膜炎降钙素原 C反应蛋白　出处：《青岛大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的：观察降钙素原(PCT)、CRP和WBC在慢性乙型肝炎(CHB)肝硬化伴自发性腹膜炎(SBP)患者血清中的变化,并分析三者对于临床诊断SBP所具有的价值。研究方法：收集CHB肝硬化伴SBP患者50例(SBP组)、不伴SBP患者50例(非SBP组),分别测定血中WBC.CRP和PCT,并绘制受试者工作特征(ROC)曲线,记录曲线下面积(AUC)、95%可信区间(95%Cl)及特定诊断敏感性和特异性所对应的cut-off值。结果： (1)慢乙肝肝硬化伴自发性腹膜炎(SBP组)与不伴自发性腹膜炎(非SBP组)血PCT.CRP及WBC均存在差异。SBP组PCT、CRP及WBC水平分别为0.599±0.196ng/mL、22.470±8.213mg/L和7.669±2.572x109/L。而非SBP组PCT、CRP及WBC水平分别为0.291±0.121ng/mL、8.976±5.504mg/L和4.494±1.859x109/L。与非SBP组相比,SBP组血CRP、PCT、WBC均明显升高(P均0.05)。(2)PCT的曲线下面积(AUC)、95%置信区间(95%Cl)、90%敏感性和86%的特异性所对应的cut-off值分别为0.926、0.875-0.977、0.415mg/L.CRP和WBC对应的分别是AUC:0.911;95%Cl:0.858.0.964;70%敏感性/90%特异性；17.15mg/L和AUC:0.852；95%CI:0.779-0.925；66%敏感性/80%特异性；6.27×109/L。PCT与CRP的AUC均显著大于WBC,有统计学意义(P均0.05),PCT与CRP的cut-off值分别为0.415ng/mL、17.15mg/L.而且经过相关检验发现PCT与CRP、WBC均呈线性正相关,r值分别为0.743、0.712。结论：慢乙肝肝硬化失代偿期伴自发性腹膜炎(SBP)患者血WBC及CRP、PCT水平显著升高,后两者诊断SBP的价值更高。
[Abstract]:Objective: to observe the changes of serum levels of procalcitonin (WBC) and procalcitonin in patients with chronic hepatitis B (CHB) cirrhosis with spontaneous peritonitis (SBP). The value of the three factors in clinical diagnosis of SBP was analyzed. Methods: the serum WBC.CRP and PCT were measured in 50 patients with CHB cirrhosis with SBP and 50 patients without SBP (non-#en3# group). The ROC curve was drawn and the area under the curve was recorded. 95% CI 95 CI) and the cut-off values corresponding to the sensitivity and specificity of a specific diagnosis. Results: (1) there was significant difference in serum PCT.CRP and WBC between patients with chronic hepatitis B cirrhosis with spontaneous peritonitis (SBP group) and those without spontaneous peritonitis group (non-SBP group). The levels of CRP and WBC were 0.599 卤0.196 ng / mL. 22.470 卤8.213 mg / L and 7.669 卤2.572 x 109 / L, instead of PCT in the SBP group. The levels of CRP and WBC were 0.291 卤0.121 ng / mL. 8.976 卤5.504 mg / L and 4.494 卤1.859 x 109 / L, respectively. The area under the curve of WBC increased significantly (P < 0.05). The 95% confidence interval (CI) of AUC was 95%. The cut-off values corresponding to the sensitivity of 90% and the specificity of 86% were 0.926 ~ 0.875-0.977, respectively. The corresponding values of 0.415 mg / L CRP and WBC were AUC: 0.911; 95 Cl: 0.858.0.964; 70% sensitivity / 90% specificity; 17.15 mg / L and AUC: 0.852; 95 CI: 0.779-0.925; 66% sensitivity / 80% specificity; The AUC of 6.27 脳 10 9 / L PCT and CRP were significantly higher than that of WBC (P < 0.05). The cut-off values of PCT and CRP were 0.415 ng / mL and 17.15 mg / L, respectively. The linear positive correlation between PCT and CRP was found by correlation test. R values were 0.743 and 0.712, respectively. Conclusion: The serum levels of WBC and SBP in patients with decompensated chronic hepatitis B cirrhosis with spontaneous peritonitis were significantly increased, and the latter two were more valuable in the diagnosis of SBP.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62;R575.2

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