老年肝硬化合并细菌性腹膜炎患者血清sTREM-1、sCD14、LBP水平变化及其对患者预后的影响

Changes in Serum Levels of sTREM-1,sCD14,and LBP in Elderly Patients with Liver Cirrhosis and Bacterial Peritonitis and their Impact on Patient Prognosis

【目的】探讨老年肝硬化并发细菌性腹膜炎(SBP)患者血清可溶性髓样细胞触发受体-1(sTREM-1)、可溶性白细胞分化抗原14(sCD14)、脂多糖结合蛋白(LBP)变化情况。【方法】选取2020年8月至2022年3月本中心和新乡市中心医院收治的108例老年肝硬化合并SBP患者(观察组),108例老年肝硬化未合并SBP患者为对照组。根据治疗9~12 d后预后情况将观察组患者分为预后不良组(n=38)和预后良好组(n=70)。比较不同组别患者治疗前血清sTREM-1、sCD14、LBP水平,采用Logistic回归分析影响老年肝硬化合并SBP的危险因素。【结果】治疗前,观察组血清sTREM-1、sCD14、LBP水平均高于对照组,差异有统计学意义(P<0.05)。Logistic回归分析显示,治疗前血清sTREM-1>55.49μg/mL、sCD14>24.94 mg/L、LBP>90.79μg/L是老年肝硬化合并SBP的危险因素(P<0.05)。治疗后,预后良好组血清sTREM-1、sCD14、LBP水平低于治疗前(P<0.05),预后不良组高于预后良好组(P<0.05)。肝硬化合并SBP患者血清sTREM-1、sCD14、LBP高水平患者预后不良的危险度是低水平的2.116倍、2.992倍、2.088倍(P<0.05)。【结论】血清sTREM-1、sCD14、LBP水平异常升高可诱发肝硬化合并SBP,检测其表达水平可为临床预测肝硬化合并SBP患者预后提供参考。

【Objective】To investigate the changes in sTREM-1,sCD14,and lipopolysaccharide binding protein(LBP)in elderly patients with liver cirrhosis complicated with bacterial peritonitis(SBP).【Methods】A total of 108 elderly patients with liver cirrhosis and SBP admitted to our center and Xinxiang Central Hospital from August 2020 to March 2022 were selected as the observation group,while 108 elderly patients with liver cirrhosis without SBP were selected as the control group.According to the prognosis after 9-12 days of treatment,patients in the observation group were divided into a poor prognosis group(n=38)and a good prognosis group(n=70).The serum levels of sTREM-1,sCD14,and LBP were compared among different groups of patients before treatment,and logistic regression analysis was used to analyze the risk factors of elderly cirrhosis with SBP.【Results】Before treatment,the serum levels of sTREM-1,sCD14,and LBP in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).Logistic regression analysis showed that serum sTREM-1>55.49μg/mL,sCD14>24.94 mg/L,and LBP>90.79μg/L before treatment were risk factors for elderly cirrhosis with SBP(P<0.05).After treatment,the serum levels of sTREM-1,sCD14,and LBP in the group with good prognosis were lower than before treatment(P<0.05),while those in the group with poor prognosis were higher than those in the group with good prognosis(P<0.05).The risk of poor prognosis in patients with high levels of serum sTREM-1,sCD14,and LBP in patients with cirrhosis and SBP was 2.116 times,2.992 times,and 2.088 times higher than that in patients with low levels(P<0.05).【Conclusion】Abnormal elevation of serum levels of sTREM-1,sCD14,and LBP can induce cirrhosis with SBP.Detecting their expression levels can provide a reference for clinical prediction of prognosis in patients with cirrhosis with SBP.