联合检测腹水肝素结合蛋白及钙卫蛋白在自发性细菌性腹膜炎诊断中的研究分析

Significance of combined detection of HBP and CP in the diagnosis of spontaneous bacterial peritonitis

目的探讨腹水肝素结合蛋白(heparine-binding protein,HBP)和钙卫蛋白(calprotection,CP)在肝硬化腹水患者伴自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)中的诊断意义。方法选取本院2017年1月—2019年10月收治的失代偿性肝硬化腹水患者70例,其中SBP组32例,非SBP组38例。检测2组患者腹水中HBP、CP水平,比较SBP组抗菌药物使用前后2个指标水平变化。分析了HBP及CP与腹水多形核白细胞(poly morphonuclear,PMN)计数的相关性,同时分析上述指标对SBP的敏感度、特异度。结果SBP组患者腹水HBP、CP水平显著高于非SBP组;同时,SBP组患者治疗后腹水HBP、CP水平显著低于治疗前,差异均有统计学意义(P<0.05)。两者对于早期诊断SBP敏感度及特异度均较高。结论肝硬化SBP患者的腹水HBP及CP水平显著高于非SBP组,两者均可以作为早期诊断SBP敏感度及特异度较好的指标,两者联合检测可进一步提高SBP诊断效能,指导临床早期干预,值得临床应用推广。

Objective To investigate the diagnostic significance of heparin binding protein(HBP)and calprotectin(CP)in ascites of patients with cirrhosis and ascites accompanied by spontaneous bacterial peritonitis(SBP).Methods Seventy cases of decompensated cirrhosis ascites admitted to our hospital from January 2017 to October 2019 were included.There were 32 cases in SBP experimental group and 38 cases in non SBP control group.The levels of HBP and CP in ascites of the two groups were analyzed,and the changes of the two indexes before and after the use of antibiotics in SBP group were compared.At the same time,HBP and CP were correlated with the number of poly morphonuclear leukocytes(PMN)in ascites.The sensitivity and specificity of the above inflammatory indexes to SBP were analyzed.Results The levels of HBP and CP in ascites of SBP group were significantly higher than those of non SBP group.At the same time,the HBP and CP levels of ascites in SBP group were significantly lower than those before treatment(P<0.05).Both of them can be used as the sensitive and specific indica⁃tors for early diagnosis of SBP.Conclusion The levels of HBP and CP in ascites of SBP patients were significantly higher than those of non SBP patients.Both of them can be used as the sensitive and specific indicators for early diagnosis of SBP.The com⁃bined detection of the two can further improve the diagnosis efficiency of SBP,guide the early clinical intervention,and is worth clinical application and promotion.