血清降钙素原与腹水乳铁蛋白在自发性细菌性腹膜炎患者中的临床价值

Clinical value of serum procalcitonin and ascitic lactoferrin in spontaneous bacterial peritonitis patients

目的探讨血清降钙素原(procalcitonin,PCT)与腹水乳铁蛋白(lactoferrin,LF)在肝硬化合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)中的临床价值。方法纳入肝硬化并腹水患者91例,其中SBP患者61例,无菌性肝硬化腹水(sterile ascites,SA)患者30例。血、腹水标本送至实验室进行细胞计数、生化指标测定,免疫层析法检测血清PCT和腹水LF。结果 SBP组与SA组PCT、LF水平比较,差异有统计学意义(P均<0.05),其中SBP组PCT、LF浓度均高于SA组。PCT、LF与SBP患者Child-Pugh分级呈显著正相关(r=0.763、0.728,P均<0.05)。Child-Pugh A级PCT、LF水平最高,Child-Pugh B级次之,Child-Pugh C级最小。结论血清PCT、腹水LF水平对肝硬化合并SBP与SA有鉴别诊断意义,尤其对SBP的早期诊断和治疗有重要价值。PCT与LF可以预测SBP患者Child-Pugh分级,为疾病的临床评估提供依据。

Objective To evaluate the clinical value of serum procalcitonin （PCT） and ascitic lactoferrin （LF） in spontaneous bacterial peritonitis （SBP） patients with hepatic cirrhosis. Methods A total of 91 cirrhotic patients with ascites were collected, including 61 patients with SBP, and 30 patients with sterile ascites （SA）. Blood and ascites samples were sent to the laboratory for cell count and measurement of chemical elements. Serum PCT and ascitic LF were detected by immunochromatographic assay. Results There were significant differences of PCT and LF levels between SBP group and SA group （P 〈 0.05）. The concentrations of PCT and LF in SBP group were higher than those in SA group. PCT and LF were positively related to Child-Pugh classification in SBP patients （r = 0. 763, 0. 728, P 〈 0.05）. The PCT and LF levels were the highest in Child-Pugh A class, Child-Pugh B class took the second place, and Child-Pugh C class was minimum. Conclusion The levels of serum PCT and ascitic LF make significance in differential diagnosis of SBP and SA with hepatic cirrhosis, especially have great value in the early diagnosis and treatment of SBP. PCT and LF can predict Child-Pugh classification in patients with SBP, and provide basis for clinical evaluation of the disease.