CD64、降钙素原检测在肝硬化自发性细菌性腹膜炎诊断中的意义

Clinical significance of CD64 and procalcitonin in diagnosis of liver cirrhosis with spontaneous bacterial peritonitis

目的检测肝硬化患者CD64、血清降钙素原(PCT)水平,探讨CD64、血清PCT检测对自发性细菌性腹膜炎(SBP)的诊断价值。方法将肝硬化患者分为SBP组(45例)、腹水非SBP组(93例)及对照组3组(50例),应用流式细胞术测定CD64;电化学发光免疫法测定PCT。分别采集SBP组患者在入院后24h内、抗菌药物使用前及抗菌药物有效治疗7d空腹上肢静脉血,测定患者体内CD64、PCT水平,同时行血常规、肝功能、肾功能、凝血功能检查。腹水非SBP组及对照组一次性采血测定以上指标。结果 SBP组CD64、血清PCT水平较腹水非SBP组和对照组明显升高(P<0.01)。ROC曲线分析结果显示CD64和PCT的敏感性和特异性分别为95.5%、93.8%和96.1%、85.2%。结论 CD64、PCT可作为肝硬化SBP早期诊断、疗效判定的重要指标。

Objective To detect the level of CD64 and serum procalcitonin（PCT）and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis（SBP）.Methods Participants were categorized into three groups including liver cirrhosis with SBP（45patients）,liver cirrhosis without SBP（93patients）and health personnel（50persons）.CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay.The limosis vein blood samples were obtained from the patients with SBP at the time of 24 hafter admission,before antibacterial drugs use and 7days after the effective treatment of antibacterial drugs.The CD64 and serum PCT were detected with the limosis vein blood samples.At the same time,the complete blood count,liver,kidney and blood coagulate functions were tested.The participants in other two groups were detected the CD64,serum PCT,complete blood count,liver,kidney and blood coagulate functions at the same time.Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls（P〈0.01）.ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95.5%,93.8% and 96.1%,85.2%respectively.Conclusion CD64 and serum PCT can be determined as the important indicator in early diagnosis and efficacy criterion.