腹水及血浆降钙素原在肝硬化合并自发性细菌性腹膜炎诊断中的价值

发布时间：2018-04-24 03:24

本文选题：降钙素原 + 肝硬化　；参考：《首都医科大学学报》2015年04期

【摘要】：目的探讨腹水及血浆降钙素原在肝硬化合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)诊断中的价值,为其早期诊断提供依据。方法选取首都医科大学附属北京佑安医院2014年8月至2015年1月肝硬化腹水患者69例,其中确诊合并自发性细菌性腹膜炎的28例,未合并自发性细菌性腹膜炎的41例,进行腹水及血浆降钙素原水平检测,并进行相关统计分析。结果与非SBP组相比,SBP组腹水降钙素原(procalcitonin,PCT)、腹水白细胞(white blood cell,WBC)、腹水多形核细胞(polymorphonuclear,PMN)和血浆PCT、全血WBC检测结果均显著升高,差异有统计学意义(P0.01);同一患者同一病程时期腹水中PCT浓度与血浆PCT浓度基本一致,呈正相关,相关系数(r=0.877,P0.01);诊断自发性细菌性腹膜炎时,血浆PCT和腹水PCT曲线下面积分别为0.919和0.820,最佳临界值分别为0.415 ng/m L和0.746 ng/m L。结论腹水及血清降钙素原的检测对肝硬化腹水伴发自发性细菌性腹膜炎的早期诊断有重要价值,其具有很高的敏感性和特异性,且血浆PCT的诊断价值优于腹水PCT。
[Abstract]:Objective to investigate the value of procalcitonin in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with spontaneous bacterial peritonitis. Methods Sixty-nine patients with cirrhosis and ascites from August 2014 to January 2015 were selected from Beijing Youan Hospital affiliated to Capital Medical University. Among them, 28 cases were diagnosed with spontaneous bacterial peritonitis and 41 cases without spontaneous bacterial peritonitis. The levels of procalcitonin in ascites and plasma were detected and the correlation was analyzed. Results compared with the control group, the levels of procalcitonin in ascites, white blood cells, polymorphonuclear cell polymorphonuclear cells (PMNs), plasma PCTs and whole blood WBC were significantly increased in SBP group. The concentration of PCT in ascites of the same patient was basically consistent with the concentration of plasma PCT in the same course of disease, and the correlation coefficient was 0.87 7% P0.01. in the diagnosis of spontaneous bacterial peritonitis, the correlation coefficient was 0.87 7% (P < 0.05), and the correlation coefficient was 0.87 7% (P < 0.05). The areas under the PCT curve of plasma PCT and ascites were 0.919 and 0.820, respectively, and the optimum critical values were 0.415 ng/m L and 0.746 ng/m L, respectively. Conclusion the detection of procalcitonin in ascites and serum is of great value in the early diagnosis of spontaneous bacterial peritonitis in cirrhotic ascites with high sensitivity and specificity, and the diagnostic value of plasma PCT is superior to that of ascites.
【作者单位】：首都医科大学附属北京佑安医院临床检验中心;传染病相关疾病生物标志物北京市重点实验室;
【基金】：中医药防治重大传染病临床科研基地与技术平台建设(2012ZX10005010)~~
【分类号】：R575.2;R572.2

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