降钙素原、内毒素对自发性腹水感染的诊断价值

The value of PCT and ET in diagnosis of spontaneous ascites infection

目的探讨降钙素原(procalcitonin,PCT)、内毒素(endotoxin,ET)在自发性腹水感染中的诊断价值。方法回顾性分析肝硬化患者255例,分为自发性腹水感染组(GZ组)、无菌性腹水组(WZ组)和代偿期组(DZ组)。GZ组按脓毒症标准分为脓毒症组与非脓毒症组,按肝功能分级标准分为B级组和C级组。检测并比较患者住院期间PCT、ET浓度。结果血PCT、ET含量GZ组明显高于WZ组和DZ组,脓毒症组明显高于非脓毒症组,以PCT最显著,C级组明显高于B级组;GZ组患者腹水ET浓度明显高于血ET;所有结果差异均有统计学意义(P<0.05)。结论血PCT、ET及腹水ET浓度升高可有效诊断自发性腹水感染,可用于判断感染的严重程度,PCT对脓毒症有特异性;腹水ET诊断自发性腹水感染的敏感性高于血ET。

Objective:To investigate the diagnostic significance of PCT and ET in spontaneous ascites infection.Methods:255 patients with liver cirrhosis from June 2015 to May 2018 were collected and divided into the three groups:liver cirrhosis spontaneous ascites infection group(GZ group),cirrhosis sterile ascites group(WZ group)and liver cirrhosis compensatory control group(DZ group).GZ group was divided into sepsis group and non-sepsis group according to sepsis criteria and grade B group and grade C group according to the liver function grading criteria.PCT and ET concentrations at admission and during hospitalization were measured and compared.The results were analyzed using SPSS 22.0 software.Results:The concentrations of serum PCT and ET in GZ group at admission were significantly higher than those in non-infection group.The concentrations of serum PCT and ET in the sepsis group were significantly higher than those in the non-sepsis group,with the most significant difference in PCT,the level of serum PCT and ET in grade C group were significantly higher than those of grade B group at the time of admission;in GZ group,ET in ascites was significantly higher than that in blood.All the differences were statistically significant(P<0.05).Conclusion:PCT and ET in blood and ET in ascites are significantly increased,which can effectively diagnose spontaneous ascites infection and can be used to determine the severity of spontaneous ascites infection.PCT has a higher specificity in sepsis;The sensitivity of ascites ET in the diagnosis of spontaneous ascites infection is higher than that of blood ET.