前降钙素在慢性病毒性肝炎合并严重感染时的变化和意义

Significance of procalcitonin change in chronic viral hepatitis patients with severe infection

目的 分析慢性病毒性肝炎合并严重感染时血清前降钙素的变化及其与炎症因子、介质的关系。方法对 31例慢性病毒性肝炎合并自发性细菌性腹膜炎和败血症的患者 ,测定其血清和腹水的前降钙素 (PCT)、肿瘤坏死因子 (TNF)、内毒素 (LPS)和C反应蛋白 (CRP)。结果 合并严重感染时 ,PCT明显增高 ,增高幅度与感染程度呈正比 ,且与未合并感染者的差异有显著性 (P <0 .0 5 ) ;同时还发现PCT的增高与TNF ,LPS和CRP的升高呈正相关。结论 PCT是诊断慢性病毒性肝炎合并严重细菌感染的一个新型、敏感的实验室指标 ,对于鉴别感染与否 ,是否为细菌性感染具有较好的特异性。

Objective To analyse the relation between procalcitonin and other inflammative mediators in chronic hepatitis patients with severe infection. Methods Sera from 31 hepatitis patients with spontaneous bacterial peritonitis and septicemia were assayed for detection of procalcitonin (PCT), tumor necrotic factor (TNF), lipopolysaccharide (LPS) and c-reactive protein (CRP). Results PCT level elevated in severe infection patients, and there was significant difference in PCT between infection patients and non-infection patients (P< 0.05). PCT was positively related with TNF, LPS and CRP. Conclusion PCT is a new and sensitive indicator for diagnosis of severe bacterial infection, and has good specificity for distinguish bacterial from nonbacterial infection.