血清降钙素原检测对肝硬化合并肝肾综合征患者的诊断价值

Diagnostic value of serum procalcitonin in patients with liver cirrhosis complicated with hepatorenal syndrome

目的探讨肝硬化合并肝肾综合征患者血清降钙素原(PCT)检测的临床价值。方法选择2010年1月至2015年1月在我院综合科就诊的肝硬化患者106例,按患者是否合并肝肾综合征将其分为合并组32例和未合并组74例。另选取40例健康体检者作为对照组,检测并比较三组受检者的血清PCT水平、总胆汁酸(TBA)、胱抑素C(Cys C)、C反应蛋白(CRP)、以及白细胞计数(WBC),计算三组受检者的24 h内生肌酐清除率,分析各生化指标与血清PCT的相关性。结果合并组、未合并组和对照组受检者的PCT[(4.02±1.20)μg/L vs(0.33±0.02)μg/L vs(0.13±0.03)μg/L]、WBC[(6.03±1.03)×109/L vs(3.94±1.82)×109/L vs(5.51±1.29)×109/L]、CRP[(6.24±1.92)g/L vs(5.73±1.24)g/L vs(1.60±0.39)g/L]、Cys-C[(2.34±0.32)mg/L vs(0.79±0.11)mg/Lvs(0.67±0.20)mg/L]、TBA水平[(33.29±3.94)μmol/L vs(23.39±3.04)μmol/L vs(20.39±2.02)μmol/L]比较,合并组上述指标均高于未合并组和对照组,差异均具有统计学意义(P<0.05);合并组的24 h-Ccr水平为(62.48±6.02)m L/min,明显低于未合并组的(83.12±8.22)m L/min和对照组的(90.38±8.34)m L/min,差异均具有统计学意义(P<0.05);血清PCT与24 h-Ccr呈负相关(r未合并组=-0.278,r合并组=-0.600),与患者的CRP呈正相关(r未合并组=0.244,r合并组=0.605),与患者的Cys-C水平呈正相关(r未合并组=0.247,r合并组=0.530)。结论肝硬化患者的血清PCT升高,则其患有合并肝肾综合征的概率较高,血清PCT在诊断肝硬化合并肝肾综合征中具有较高的诊断价值。

Objective To study the diagnostic value of serum procalcitonin(PCT) in patients with liver cirrhosis complicated with hepatorenal syndrome. Methods A total of 106 patients with liver cirrhosis were selected from January 2010 to January 2015 in our hospital, which were divided into two groups according to whether the patients were complicated with hepatorenal syndrome: 32 cases with hepatorenal syndrome(group A) and 74 cases without hepatorenal syndrome(group B). Another 40 subjects with good health were selected as the control group. The serum PCT levels, total bile acid(TBA), Cystatin C(Cys C), C-reactive protein(CRP), and white blood cell count(WBC) of three groups were tested and compared, and the 24 h creatinine clearance rate(Ccr) of three groups was calculated. The correlation between biochemical indexes and serum PCT was analyzed. Results The PCT((4.02±1.20) μg/L vs(0.33±0.02) μg/L vs(0.13±0.03) μg/L), WBC((6.03±1.03)×109/L vs(3.94±1.82)×109/L vs(5.51±1.29)×109/L), CRP((6.24±1.92) g/L vs(5.73±1.24) g/L vs(1.60±0.39) g/L), Cys-C((2.34±0.32) mg/L vs(0.79±0.11) mg/L vs(0.67±0.20) mg/L), TBA((33.29±3.94) μmol/L vs(23.39±3.04) μmol/L vs(20.39±2.02) μmol/L) were significantly higher in group A than group B and the control group(P<0.05). The 24 h Ccr level was significantly lower than in group A than group B and the control group((62.48±6.02) m L/min vs(83.13±8.22) m L/min vs(90.38±8.34) m L/min), P<0.05. PCT was negatively correlated with 24 h Ccr(rgroup B=-0.278, rgroup A=-0.600), positively correlated with the level of CRP(rgroup B=0.244, rgroup A=0.605),and positively correlated with Cys-C(rgroup B=0.247, rgroup A=0.530). Conclusion The possibility of patients with cirrhosis suffering from hepatorenal syndrome is higher for patients with increased PCT level. Serum PCT has a high value in the diagnosis of liver cirrhosis complicated with hepatorenal syndrome.