血清PCT、CRP、IL-8和IL-10联合检测在诊断肝硬化合并腹水感染中的临床应用

Clinical application of combined detection of serum PCT, CRP, IL-8 and IL-10 in the diagnosis of cirrhosis with ascites infection

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素(IL-8)、IL-10联合检测在肝硬化合并腹水感染中诊断中的价值。方法:采用系统分层抽签方式选取肝硬化腹水患者96例,其中48例合并腹水感染患者(合并感染组),48例为单纯肝硬化腹水患者(非感染组),另外选择48例同期体检的健康者为对照组。测定三组受试者血清PCT、CRP、IL-8和IL-10水平,分析其与肝功能指标谷草转氨酶(AST)及谷丙转氨酶(ALT)相关性,各指标单独及联合测定在肝硬化合并腹水感染诊断中的价值。结果:三组受试者血清PCT、CRP、IL-8、IL-10水平比较差异存在统计学意义(P<0.05)。组间两两比较,非感染组血清PCT、CRP、IL-8、IL-10水平均明显高于对照组;合并感染组则明显高于非感染及对照组(P<0.05)。肝硬化合并腹水感染者血清PCT、CRP、IL-8、IL-10与AST、ALT水平间呈显著正相关(P<0.05)。ROC曲线分析,PCT在肝硬化合并腹水感染诊断中价值最高,曲线下面积(AUC)为0.776,其次为CRP(0.723)、IL-10(0.685),IL-8(0.606)最差。PCT+CRP+IL-8+IL-10联合检测肝硬化合并腹水感染的灵敏度(97.2%)及诊断符合率(92.3%)均显著高于四项指标单独检测和两两联合、PCT+CRP+IL-8、PCT+CRP+IL-10联合检测(P<0.05)。结论:肝硬化合并腹水感染患者血清PCT、CRP、IL-8和IL-10均出现异常升高,其可辅助诊断患者感染与否及肝损伤程度,尤其是四项联合检测在肝硬化合并腹水感染中具有较高灵敏度,同时可弥补单项指标测定诊断符合率低的缺点。

Objective:To investigate the value of combined detection of serum procalcitonin(PCT),C-reactive protein(CRP),interleukin(IL-8)and IL-10 in the diagnosis of cirrhosis with ascites infection.Methods:96 patients were selected from patients with cirrhosis and ascites admitted by systematic stratified drawing.Among those,48 patients with ascites infection(combined infection group),48 patients with simple cirrhosis ascites(non-infected group),48 healthy patients with the same physical examination were selected as the control group.Serum PCT,CRP,IL-8 and IL-10 levels were measured in three groups,and their correlation with liver function indexes aspartate aminotransferase(AST)and alanine aminotransferase(ALT)were analyzed.The indicators were measured separately and in combination with cirrhosis.The value of combined diagnosis of ascites infection.Results:There were significant differences in serum PCT,CRP,IL-8 and IL-10 levels between the three groups(P<0.05).Compared with the control group,the levels of PCT,CRP,IL-8 and IL-10 in the non-infected group were significantly higher than those in the control group(P<0.05).There was a significant positive correlation between serum PCT,CRP,IL-8,IL-10 and AST and ALT levels in patients with cirrhosis and ascites(P<0.05).ROC curve analysis showed that PCT had the highest value in the diagnosis of cirrhosis with ascites infection,and the area under the curve(AUC)was 0.776,followed by CRP(0.723),IL-10(0.685),and IL-8(0.606).The sensitivity of PCT+CRP+IL-8+IL-10 combined detection of cirrhosis with ascites infection(97.2%)and diagnostic coincidence rate(92.3%)were significantly higher than the four indicators alone and combined,PCT+CRP+IL-8,PCT+CRP+IL-10(P<0.05).Conclusion:The serum levels of PCT,CRP,IL-8 and IL-10 in patients with cirrhosis and ascites are abnormally elevated,which can assist in the diagnosis of infection and liver damage,especially in the combined detection of cirrhosis and ascites infection.It has high sensitivity and can make up for the shortcomings of low diagnostic accuracy of single index measurement.