血清降钙素原及C-反应蛋白的联合检测在肝硬化合并自发性细菌性腹膜炎诊断中的临床价值

Clinical value of serum PCT and CRP combination detection in diagnosis of liver cirrhosis complicating spontaneous bacterial peritonitis

目的探讨血清降钙素原(PCT)及C-反应蛋白(CRP)联合检测在肝硬化合并自发性细菌性腹膜炎患者早期诊断中的价值。方法收集临床诊断为肝硬化伴自发性细菌性腹膜炎患者(SBP组)30例、单纯性腹水肝硬化患者(非SBP组)30例及40例健康者作为对照组的外周血标本,采用干式免疫荧光定量法检测血清PCT水平,同时采用免疫比浊法测定血清CRP的水平。比较PCT、CRP及PCT+CRP在诊断肝硬化合并自发性细菌性腹膜炎中的敏感性与特异性,并分析PCT水平与预后的关系。结果与健康对照组及非SBP组比较,SBP组患者血清PCT与CRP水平均显著升高(P<0.05)。在诊断肝硬化合并SBP感染中,PCT、CRP及PCT+CRP的敏感性分别为93.3%、90.0%和96.6%,特异性分别为90.0%、75.0%和95.0%。结论联合检测血清PCT和CRP能够提高诊断的敏感性及特异性,对肝硬化合并SBP患者早期诊断更具有临床价值。

Objective To explore the clinical value of serum procalcitonin（PCT）and C-reactive protein（CRP）combination detec-tion in early diagnosis of liver cirrhosis complicating spontaneous bacterial peritonitis（SBP）.Methods The peripheral blood sam-ples were collected from 30 cases of liver cirrhosis complicating SBP,30 cases of simple ascites liver cirrhosis （non-SBP）and 45 healthy subjects as control group.The serum PCT level was detected by the dry immunofluorescence quantitation method and the serum CRP level was detected by the immunoturbidimetry.The sensitivity and specificity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis complicating SBP were compared and the relationship between PCT levels and prognosis was ana-lyzed.Results Compare with the healthy control group and the non-SBP group,the serum PCT and CRP levels in the SBP group were markedly increased（P 〈0.05）.The sensitivity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis compli-cating SBP was 93.3%,90.0% and 96.6% respectively,and the specificity was 90.0%,75.0% and 95.0% respectively.Conclusion The combination detection of serum PCT and CRP can increase the sensitivity and specificity of the diagnosis and has more clini-cal value in early diagnosing liver cirrhosis complicating SBP.