联合检测降钙素原与血清淀粉样蛋白A在肝硬化合并腹水感染中的临床应用价值

Clinical value of combined detection of serum PCT and SSA in cirrhotic with ascites infection

目的探讨联合检测血清降钙素原(PCT)及血清淀粉样蛋白A(SAA)在肝硬化合并腹水感染中的应用价值,为肝硬化合并腹水感染的诊断提供参考。方法选取2018年6月~2019年11月确诊的102例肝硬化伴腹水患者作为观察组,根据腹水有无感染,分为感染组(38例)和非感染组(64例);选取同时期40例体检者作为健康对照组。比较三组患者血清PCT及SAA水平,探讨血清PCT、SAA水平对肝硬化腹水感染的诊断效能。结果感染组血清PCT、SAA水平(4.35±1.15 ng/ml、28.58±6.35 mg/L)均显著高于非感染组(0.25±0.29 ng/ml、4.53±0.56 mg/L)及对照组(0.34±0.56 ng/ml、3.79±0.73 mg/L),差异均有统计学意义(P<0.05),非感染组与对照组相比,PCT、SAA水平差异无统计学意义(P>0.05)。血清PCT、SAA用于诊断腹水感染的灵敏度、特异度均在80%以上,曲线下面积分别为0.873、0.821;PCT及SAA联合检测灵敏度及特异度均明显升高,分别为90.78%、94.56%,曲线下面积为0.932。结论血清PCT、SAA在肝硬化腹水合并感染时会明显升高,可用于腹水感染的诊断,对无明显腹水感染症状的患者如存在血清PCT、SAA明显升高,排除其他部位感染,建议早期抗生素治疗。

Objective To investigate the value of combined detection of serum procalcitonin(PCT)and serum amyloid protein A(SAA)in the diagnosis of cirrhosis with ascites infection,so as to provide a reference for the diagnosis of cirrhosis with autoascites infection.Methods 102 patients with cirrhosis and ascites diagnosed in our hospital from June 2018 to November 2019 were selected as the observation group.According to whether ascites were infected or not,they were divided into the infected group(38 cases)and the non-infected group(64 cases).40 cases of physical examination were selected as healthy control group.Serum PCT and SAA levels in 3 groups were compared to investigate the diagnostic efficacy of serum PCT and SAA levels on cirrhotic ascites infection.Results The levels of PCT and SAA in the infected group(4.35±1.15 ng/ml,28.58±6.35 mg/L)were significantly higher than those in the non-infected group(0.25±0.29 ng/ml,4.53±0.56 mg/L)and the control group(0.34±0.56 ng/ml,3.79±0.73 mg/L),all with statistically significant differences(P<0.05).The sensitivity and specificity of serum PCT and SAA in the diagnosis of ascites infection were above 80%,and the areas under the curve were 0.873 and 0.821,respectively.The detection sensitivity and specificity of PCT and SAA were significantly increased,which were 90.78%and 94.56%,respectively,and the area under the curve was 0.932.Conclusion Serum PCT and SAA are significantly increased in cirrhotic ascites complicated with infection,which can be used for the diagnosis of ascites infection.For patients without obvious symptoms of ascites infection,if the serum PCT and SAA are significantly increased,other site infections are excluded,and early antibiotic treatment is recommended.