肝硬化伴自发性细菌性腹膜炎患者血浆及腹水降钙素原检测临床意义

Clinical significance of detection of plasma and ascitic procalcitonin in cirrhotic patients with spontaneous bacterial peritonitis

探讨血浆及腹水降钙素原 (Procalcitonin ,PCT)检测在肝硬化伴自发性细菌性腹膜炎 (SBP)患者临床意义。采用免疫发光法测定 6 2例肝硬化腹水患者 (SBP 4 1例、非SBP 2 1例 )血浆及腹水PCT水平 ,并与TNF -α、IL - 6水平比较。SBP组血浆及腹水PCT、TNF -α和IL - 6水平均显著高于非SBP组 (P <0 0 1)。均以非SBP组均数加 2倍标准差为阳性判断值时 ,血浆PCT对SBP诊断阳性预测值最高 ,腹水IL - 6阴性预测值最高。死亡组入院时血浆PCT、TNF -α和IL - 6水平均显著高于同期存活组水平 ,腹水各项指标测定价值有限。血浆PCT水平是诊断肝硬化伴SBP和预后判断的有效指标。

To explore the clinical significance of plasma and ascitic procalcitonin (PCT) levels in cirrhotic patients with spontaneous bacterial peritonitis (SB). Plasma and ascitic PCT levels in 62 ascitic patients (SBP 41 and non SBP 21) were detected by immunoluminometric assay, and compared with TNF-α、IL-6 levels. Plasma and ascitic PCT、TNF-α and IL-6 levels were significantly higher in SBP group than that in non SBP group (P<0.01). In diagnosis of SBP, the positive predictive value (non SBP group x+2SD as the cutoff value) was the highest by plasma PCT than by the others, while the highest negative predictive value was ascitic IL-6. Plasma PCT、TNF-α and IL-6 levels in the death at admission were significantly higher than that in the survivals at the same time, but no in ascitic fluid. Plasma PCT level can be used as a useful indicator to the diagnosis and prognosis in cirrhotic patients with SBP.