肝硬化合并自发性腹膜炎患者降钙素原和C反应蛋白检测的临床意义

Clinical value of procalcitonin and C-reactive protein test in liver cirrhotic patients with spontaneous bacterial peritonitis

目的探讨肝硬化患者血清、腹水降钙素原(PCT)和血清C反应蛋白(CRP)水平对肝硬化合并自发性细菌性腹膜炎(SBP)诊断的临床意义。方法选择肝硬化腹水患者73例,单纯腹水39例(无SBP组),肝硬化合并SBP 34例(SBP组),进行腹水和血清的PCT以及血清的CRP水平检测。结果SBP组和无SBP组血清CRP水平分别为(76.00±60.75)mg/L和(16.00±43.00)mg/L(P<0.01);以PCT≥2μg/L为阳性标准,SBP组血清和腹水PCT阳性率高于无SBP组(血清79.4%vs 10.3%,腹水29.4%vs 5.1%,P<0.01);SBP组患者治疗好转后血清和腹水的PCT阳性率较治疗前明显下降(16.7%vs 3.3%,P<0.01)。血清CRP及PCT联合检查有助于提高SBP诊断的敏感度、特异度和准确度。结论血清和腹水PCT及血清CRP检测对肝硬化合并SBP早期诊断具有一定的临床意义。

Objective To investigate the clinical value of serum and ascitic procalcitonin（PTC） and C-reactive protein level in diagnosing liver cirrhosis with spontaneous bacterial peritonitis（SBP）. Methods Seventy-three patients with liver cirrhosis and ascites were selected, 39 of them were simple ascites, others liver cirrhosis with SBP. Serum PCT,ascitic PTC and serum CRP of all these patients were checked. Results Serum CRP of liver cirrhotic patients with SBP was （76.00±60.75） mg/L,while that of the patients with simple ascites was （16.00±43.00） mg/L. The level of PCT was significantly different between two groups at a cut of level of PCT ≥2 μg/L （serum PCT was 79.4% vs 10.3% ,ascitic PTC was 29.4% vs 5.1%, P 〈0.01）. Serum and ascitic PTC level went down when the patients with SBP improved （16.7% vs 3.3%, P 〈 0.01）. Checking serum PCT,CRP and ascitic PTC at the same time can help increase the sensitivity, specificity and accuracy in diagnosing liver cirrhosis with SBP. Conclusion Checking serum PCT,CRP and ascitic PCT have clinical significance on the initial diagnosis of liver cirrhosis with SBP.