血清IL-15和sCD14-ST及急性时相蛋白水平对诊断肝炎肝硬化患者合并感染的价值

Diagnostic value of serum IL-15,sCD14-ST and acute phase protein in patients with hepatitis cirrhosis complicated with infection

目的探讨血清白细胞介素-15(IL-15)、可溶性白细胞分化抗原14亚型(sCD14-ST)、急性时相蛋白水平对诊断肝炎肝硬化患者合并感染的价值。方法选取2017年1月-2020年1月焦作市第二人民医院收治的肝炎肝硬化患者102例,其中合并感染者46例(感染组),未发生感染者56例(未感染组)。收集患者临床资料,检测血清IL-15、sCD14-ST、C反应蛋白(CRP)、触珠蛋白(HPT)、铜蓝蛋白(CER)、α1-酸性糖蛋白(AAG)、白蛋白、降钙素原(PCT)、白细胞计数(WBC)、中性粒细胞/淋巴细胞(NLR)、总胆红素水平。肝炎肝硬化合并感染的相关因素分析采用多因素Logistic回归分析,采用受试者工作特征曲线(ROC)和曲线下面积(AUC)评估血清sCD14-ST、CRP、HPT、CER、AAG诊断肝炎肝硬化合并感染的价值,血清指标之间的相关性分析采用Pearson相关分析。结果两组患者在肝功能分级、饮酒嗜好、白蛋白、PCT、WBC、NLR、总胆红素、sCD14-ST、CRP、HPT、CER、AAG等方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,饮酒嗜好以及血清sCD14-ST、CRP、HPT、CER、AAG水平是感染发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清sCD14-ST、CRP、HPT、CER、AAG诊断肝炎肝硬化合并感染的AUC值分别为0.863、0.850、0.880、0.790、0.782,联合检测的AUC值为0.993,明显高于单一检测,差异有统计学意义(P<0.05)。血清sCD14-ST、CRP、HPT、CER、AAG中任意两项指标之间呈显著正相关(P<0.05)。结论肝炎肝硬化患者血清sCD14-ST、CRP、HPT、CER、AAG对感染发生均有较高的诊断价值,且指标之间存在明显的相关性,联合检测可提高诊断效能。

Objective To explore the diagnostic value of serum interleukin-15(IL-15),soluble leukocyte differentiation antigen 14-subtype(sCD14-ST)and acute phase protein in patients with hepatitis cirrhosis complicated with infection.Methods A total of 102 patients with hepatitis cirrhosis who were admitted to Jiaozuo Second People’s Hospital between January 2017 and January 2020 were selected,including 46 cases with infection(infection group)and 56 cases without infection(non-infection group).The clinical data of patients were collected,and the levels of serum IL-15,sCD14-ST,Creactive protein(CRP),haptoglobin(HPT),ceruloplasmin(CER),α1-acid glycoprotein(AAG),albumin,procalcitonin(PCT),white blood cell count(WBC),neutrophil/lymphocyte(NLR)and total bilirubin were detected.Related factors of hepatitis cirrhosis with infection were analyzed by multivariate logistic regression analysis,and the receiver operating characteristic curve(ROC)and area under curve(AUC)were used to evaluate the value of serum sCD14-ST,CRP,HPT,CER and AAG in the diagnosis of hepatitis cirrhosis with infection,and Pearson correlation analysis was used to analyze the correlation among serum indexes.Results There were statistically significant differences between the two groups of patients in terms of liver function classification,drinking habits,albumin,PCT,WBC,NLR,total bilirubin,sCD14-ST,CRP,HPT,CER and AAG(P<0.05).Multivariate logistic regression analysis showed that drinking habits and levels of serum sCD14-ST,CRP,HPT,CER and AAG were independent risk factors for the occurrence of infection(P<0.05).ROC curve analysis showed that the AUC values of serum sCD14-ST,CRP,HPT,CER and AAG in the diagnosis of hepatitis cirrhosis with infection were 0.863,0.850,0.880,0.790 and 0.782,respectively,and the AUC value with 0.993 of the combined detection was significantly higher than those of single detection(P<0.05).Serum sCD14-ST,CRP,HPT,CER and AAG showed a significant positive correlation between any two indexes(P<0.05).Conclusions Serum sCD14-ST,CRP,HPT,CER and AAG in patients with hepatitis cirrhosis had a high diagnostic value on the occurrence of infection,and there was a significant correlation among indexes.Combined detection could improve the diagnostic efficacy.