血清降钙素原联合c反应蛋白及白细胞介素-6对肝硬化腹水自发性腹膜炎的诊断价值

Diagnostic value of serum procalcitonin combined with C-reactive protein and interleukin-6 in spontaneous peritonitis of cirrhotic ascites

目的探讨血清降钙素原(PCT)联合C反应蛋白(CRP)及白细胞介素-6(IL-6)对肝硬化腹水自发性腹膜炎的诊断价值。方法选取山西省中西医结合医院2016年1月至2018年3月收治的肝炎后肝硬化合并腹水患者136例,其中并发自发性腹膜炎的74例患者作为腹膜炎组,未并发自发性腹膜炎的62例患者作为非腹膜炎组,另选取健康体检者74例作为健康组。回顾性分析三组血清PCT、CRP、IL-6的检测结果,判定其应用价值。结果腹膜炎组PCT、CRP、IL-6阳性率高于健康组和非腹膜炎组,非腹膜炎组PCT、CRP、IL-6阳性率高于健康组,差异有统计学意义(P<0.05);PCT+CRP+IL-6联合检测的曲线下面积为0.962(95%CI:0.928~0.995),其诊断价值优于PCT、CRP、IL-6单独及两两联合检测。结论PCT、CRP、IL-6三种血清炎性标志物联合检测的灵敏度和特异度高,可有效提高肝炎后肝硬化患者发生自发性腹膜炎的诊断准确率。

Objective To investigate the diagnostic value of serum procalcitonin(PCT)combined with C reactive protein(CRP)and interleukin-6(IL-6)in spontaneous peritonitis of cirrhosis ascites.Methods A total of 136 patients who had post-hepatitis cirrhosis complicated with ascites who were treated in Shanxi Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to March 2018 were selected as research objects.Of them,74 patients with spontaneous peritonitis were treated as peritonitis group,and 62 patients without spontaneous peritonitis were treated as non-peritonitis group.Another 74 healthy persons who underwent physical examination were selected as healthy group.The results of PCT,CRP and IL-6 in serum of three groups were analyzed retrospectively,and their application value was judged.Results The positive rates of PCT,CRP and IL-6 in peritonitis group were higher than those in healthy group and non-peritonitis group,the positive rates of PCT,CRP and IL-6 in non-peritonitis group were higher than those in healthy group(P<0.05).The area under the curve of PCT+CRP+IL-6 was 0.962(95%CI:0.928-0.995).The diagnostic value of PCT+CRP+IL-6 was better than that of PCT,CRP and IL-6 alone or in combination.Conclusions The combined detection of PCT,CRP and IL-6 has high sensitivity and specificity,which can effectively improve the diagnostic accuracy of spontaneous peritonitis in patients with post-hepatitis cirrhosis.