肝硬化患者腹水感染与血清降钙素原的相关性分析

发布时间：2018-08-30 12:58

【摘要】：目的探讨肝硬化患者腹水感染与血清降钙素原(PCT)的相关性,为肝硬化腹水感染的诊断提供参考。方法选择2013年4月-2015年4月于医院接受治疗的50例病毒性肝炎肝硬化腹水细菌性腹膜炎患者作为试验组,另选取50例病毒性肝炎腹水未感染患者作为对照组,采集试验组患者腹水样本,予以细菌培养、鉴定及药敏试验,同时检测两组患者血清PCT、多形核白细胞(PMN)、白细胞(WBC)数,观察患者腹水中细菌培养阳性率及血清PCT检测结果分布、各时段PTC浓度变化。结果试验组患者腹水样本共分离出病原菌133株,革兰阳性菌共52株占39.10%,革兰阴性菌65株占48.87%,真菌15株占11.28%,抗酸杆菌1株占0.75%;试验组患者血清中PTC、PMN、WBC检测结果均显著高于对照组,比较差异有统计学意义(P0.05);血清PCT以0.5ng/ml为阳性界值,则血清PCT对腹膜炎诊断敏感度为96.00%,对照组全为阴性。试验组患者随着治疗的介入,腹水感染得到改善,其血清中PCT水平也随之降低,而对照组患者血清中PCT水平则变化不明显。结论肝硬化患者中血清PCT和腹水感染成正相关,且具有较高的敏感性,对肝硬化腹水感染患者的诊断及治疗有着较高的临床参考价值。在对肝硬化腹水感染患者治疗时要合理对抗菌药物进行选择,并及时进行细菌培养和药敏试验。
[Abstract]:Objective To investigate the correlation between ascites infection and serum procalcitonin (PCT) in patients with cirrhosis and to provide reference for the diagnosis of ascites infection in cirrhosis.Methods 50 patients with viral hepatitis and ascites bacterial peritonitis who were treated in hospital from April 2013 to April 2015 were selected as experimental group and 50 patients with viral hepatitis and ascites were not infected. Patients with infection were taken as control group. Ascites samples of test group were collected for bacterial culture, identification and drug susceptibility test. Serum PCT, polymorphonuclear leukocyte (PMN) and white blood cell (WBC) were detected in both groups. The positive rate of bacterial culture in ascites, the distribution of serum PCT test results, and the changes of PTC concentration in each period were observed. A total of 133 pathogenic bacteria were isolated from the water samples, 52 of them were Gram-positive bacteria (39.10%), 65 of them were Gram-negative bacteria (48.87%), 15 of them were fungi (11.28%) and 1 of them was acid-fast bacilli (0.75%). The results of PTC, PMN and WBC in the serum of the experimental group were significantly higher than those of the control group (P 0.05), and the PCT in the serum was 0.5 ng/ml as the positive limit, while the blood was 0.5 ng/ml as the positive limit. The sensitivity of serum PCT to the diagnosis of peritonitis was 96.00%. The control group was all negative. With the intervention of treatment, ascites infection was improved in the experimental group, and the serum PCT level was also decreased, while the serum PCT level in the control group was not significantly changed. Sensitivity has a high clinical reference value for the diagnosis and treatment of cirrhosis patients with ascites infection. In the treatment of cirrhosis patients with ascites infection, it is necessary to select reasonable antibiotics, and timely bacterial culture and drug sensitivity test.
【作者单位】：重庆医科大学附属永川医院消化内科;重庆医科大学附属永川医院感染科;
【基金】：重庆市卫生局基金资助项目(2012-2-177)
【分类号】：R575.2

【相似文献】