CD32、CD64和PCT在肝硬化合并自发性细菌性腹膜炎患者腹水中的水平及诊断意义

The levels and diagnostic significance of CD32, CD64 and PCT in ascites of patients with liver cirrhosis complicated by spontaneous bacterial peritonitis

目的探讨CD32、CD64和PCT在肝硬化合并自发性细菌性腹膜炎(SBP)患者腹水中的水平及诊断意义。方法选取2015年1月到2018年6月收治的160例肝硬化并腹水患者作为研究对象,并根据是否发生SBP分为SBP组(76例)和非SBP组(84例),并同期选择80例体检健康人群作为对照组。比较3组研究人员外周血相关指标表达水平及2组患者腹水中CD32、CD64、PCT水平和SBP组治疗前后的外周血、腹水中CD32、CD64、PCT水平。结果SBP组外周血CD32、CD64、PCT、ALT、AST水平均高于非SBP组和对照组(P<0.05),非SBP组外周血CD32、CD64、PCT水平与对照组比较差异无统计学意义(P>0.05),非SBP组外周血ALT、AST水平高于对照组(P<0.05);SBP组腹水中CD32、CD64、PCT水平均高于非SBP组(P<0.05);SBP组治疗后外周血、腹水中CD32、CD64、PCT水平均低于治疗前(P<0.05),且腹水中治疗前、治疗后CD32、CD64、PCT水平均分别高于外周血中水平(P<0.05);根据ROC曲线计算得出CD32、CD64和PCT的敏感性分别为82.6%、96.1%、72.3%,特异性分别为81.1%、95.6%、76.3%。结论CD32、CD64和PCT在肝硬化合并SBP患者腹水中存在异常增高表达,对其进行检测可为SBP的早期诊断提供一定指导意义。

Objective To investigate the levels and their diagnostic significance of CD32,CD64 and PCT in ascites of patients with liver cirrhosis complicated by spontaneous bacterial peritonitis(SBP).Methods A total of 160 patients with liver cirrhosis complicated by ascites who were treated in our hospital from January 2015 to June 2018 were enrolled in the study.Acoording to whether they had SBP or not,these patients were divided into SBP group(n=76)and non-SBP group(n=84),at the same time,the other 80 healthy examinees who underwent physical examination in our hospital were enrolled as control group.The expression levels of related indexes in peripheral blood as well as the levels of CD32,CD64,PCT in ascites of patients were observed and compared between the two groups.Results The levels of CD32,CD64,PCT,ALT and AST in peripheral blood of patients in SBP group were significantly higher than those in non-SBP group and control group(P<0.05).However there were no significant differences in the levels of CD32,CD64 and PCT between non-SBP group and control group(P>0.05),however,the levels of ALT and AST in non-SBP group were significantly higher than those in control group(P<0.05).Moreover the levels of CD32,CD64 and PCT in ascites of patients in SBP group were significantly higher than those in non-SBP group(P<0.05).The levels of CD32,CD64 and PCT in peripheral blood and ascites of patients in SBP group were significantly decreased after treatment(P<0.05),furthermore,the levels of CD32,CD64 and PCT in ascites of patients before and after treatment were significantly higher than those in peripheral blood of patients(P<0.05).According to the ROC curve,the sensitivities of CD32,CD64 and PCT in diagnosis of SBP were 82.6%,96.1%,72.3%,respectively,and the specificities were 81.1%,95.6%,76.3%,respectively.Conclusion The expression levels of CD32,CD64 and PCT are abnormally increased in patients with liver cirrhosis complicated by SBP,therefor,to detect these indexes has a certain guidance significance in early diagnosis of SBP.