sCD14联合PCT检测在肝硬化并发自发性腹膜炎诊治中的应用  

Application of combination detection of sCD14 with PCT in diagnosis and treatment of hepatocirrhosis complicated by spontaneous bacterial peritonitis

作　　者：邹金海[1] 王艳生[1] 

机构地区：[1]河北省沧州市中心医院核医学科,061001

出　　处：《河北医药》2015年第15期2253-2255,共3页Hebei Medical Journal

摘　　要：目的观察肝硬化腹水并发自发性细菌性腹膜炎(SBP)患者s CD14及血清降钙素原(PCT)在诊治过程中的动态变化,探讨s CD14及PCT两者联合检测在肝硬化并发SBP患者诊治中的价值。方法回顾性分析2011年3月至2014年7月消化内科收治的肝硬化并发SBP患者136例、肝硬化腹水非SBP患者182例,另选择病毒性肝炎患者65例为对照组,所有患者入院后第1、3、5、7天监测血清s CD14及PCT水平,并将结果进行分析。结果肝硬化SBP组血清s CD14、PCT水平较肝硬化非SBP组及对照组明显升高,差异均有统计学意义(P<0.05),另SBP组血清s CD14、PCT水平随着时间的延长而升高,具有时间相关性;肝硬化SBP组中死亡患者血清s CD14、PCT浓度显著高于存活患者,s CD14、PCT水平与预后呈正相关;ROC曲线分析结果显示s CD14及PCT的敏感性和特异性分别为86.5%、80%和87.5%、85%。结论血清s CD14及PCT联合动态监测对肝硬化并发SBP诊断及判断预后比单项监测更具有临床价值。Objective To observe the dynamic changes of sCDlg and procalcitonin （PCT） in patients with hepatocirrhosis complicated by spontaneous bacterial peritonitis （SBP） , and to explore the application value of combination detection of sCD14 with PCT in diagnosis and treatment of hepatocirrhosis complicated by SBP. Methods The data of 136 patients with hepatocirrhosis complicated by SBP （SBP group） and 182 patients with hepatocirrhosis without SBP （non-SBP group） who were admitted into Department of Digestive System Diseases of our hospital from March 2011 to July 2014 were retrospectively analyzed ,besides ,65 patients with viral hepatitis were served as control group. The serum levels of sCDI4 and PCT were detected on ld,3d,5d,7d after hospitalization for all the patients. Results The serum levels of sCD14 and PCT in SBP group were significantly increased, as compared with those in non-SBOP group and control group （ P 〈 0.05）. Moreover the increase of serum levels of sCD14 and PCT was time-dependent in SBP group. The serum levels of sCD14 and PCT in death cases of SBP group were obviously higher than those in survival cases. The levels of sCDI4 and PCT were positively correlated to patient＇ s prognosis. ROC curve analysis results showed that the sensitivity and specificity of sCD14 and PCT were 86.5%, 80% as well as 87.5%, 85%, respectively. Conclusion The combined dynamic monitoring of serum sCD14 with PCT is superior to simple sCDlg detection or simple PCT detection in diagnosis and prognosis evaluation of hepatocirrhosis complicated by SBP.

关 键 词：SCD14 降钙素原 肝硬化 自发性细菌性腹膜炎 细菌感染 

分 类 号：R656.41[医药卫生—外科学]