肝硬化自发性腹膜炎患者腹水内毒素和C-反应蛋白水平的检测及临床意义

Detection and clinical significance of endotoxin and CRP in ascites of liver cirrhosis patients with spontaneous bacterial peritonitis

目的:探讨肝硬化腹水合并自发性腹膜炎患者腹水内毒素、C-反应蛋白(CRP)水平的变化及其临床意义。方法:根据腹水的性质,将58例肝炎后肝硬化腹水患者分为两组,自发性腹膜炎组(SBP)组30例,无菌性腹水组(SA)28例。应用鲎试剂动态比浊法及免疫散射比浊法测定两组患者腹水中内毒素和CRP水平并进行比较。25例SBP组患者用抗生素治疗有效后重新抽取腹水进行内毒素和CRP测定,并与治疗前结果进行比较。结果:SBP组腹水内毒素、CRP水平显著高于SA组(P<0.01),SBP组治疗前后腹水内毒素、CRP水平有差异统计学意义(P<0.01)。结论:检测腹水中内毒素和CRP的水平有助于SBP的早期诊断和疗效监测。

Objective： To study the changes and clinical significance of the levels of endotoxin and CRP in ascites in liver cirrhosis eases with spontaneous bacterial peritonitis （SBP）. Methods： According to the features of aseites, fifty - eight patients with ascites of liver cirrhosis were divided into SBP group （30 eases） and sterile asciticfluid（SA） group （28 eases）. The levels of endotoxin and CRP were measured respectively by the turbidimetric assay with limtdus reagents and RIA and con.pared between SBP group and SA group. Of 30 cases of SBP, the results of endotoxin and CRP were also compared before and after therapy with antibiotic in 25 cases of SBP. Results： There were significant differences in the levels of endotoxin and CRP in aseites between SBP group and SA group （ P 〈 0. 01 ）. The levels of endotoxin and CRP after treatment were significantly lower than those before treatment in SBP group （P 〈 0.01 ）. Conclusion： Measurement of endotoxin and CRP in ascites is helpful for physicians to diagnose SBP and observe its curative effect.