巨噬细胞炎性蛋白-1β与降钙素原在肝硬化自发细菌性腹膜炎诊断中的作用  

Role of macrophage inflammatory protein-1βand proealcitonin in diagnosis of liver cirrhosis spontaneous bacterial peritonitis

作　　者：李晓波[1] 苏杨[2] 蔺咏梅[3] 李婷[4] 陈宝银[5] 辜依海[1] 陈苗[1] 

机构地区：[1]西安交通大学附属3201医院微免科,陕西西安723000 [2]四川省人民医院检验科,四川成都610072 [3]西安交通大学附属3201医院传染病科,陕西西安723000 [4]西安交通大学附属3201医院检验科,陕西西安723000 [5]西安交通大学附属3201医院消化内科,陕西西安723000

出　　处：《国际检验医学杂志》2016年第3期308-310,313,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨早期检测巨噬细胞炎性蛋白-1β(MIP-1β)和降钙素原(PCT)在诊断肝硬化失代偿期自发性细菌性腹膜炎(SBP)中的作用。方法 2011年5月至2015年2月西安交通大学附属3201医院确诊的肝硬化失代偿期并发患者384例纳入SBP组,另外377例无SBP,肝硬化失代偿期伴腹水患者纳入对照组。收集腹水与血清标本,分别采用电化学发光法检测PCT,酶联免疫法检测MIP-1β。比较2项指标在血清和腹水检测中的意义,同时通过受试者工作特征曲线分析2项指标的临床应用价值。结果 SBP组血清和腹水中PCT及MIP-1β水平明显高于对照组,差异有统计学意义(P<0.05);在SBP组中革兰阴性菌感染患者与革兰阳性菌感染患者血清PCT比较,差异有统计学意义(P<0.05);SBP组中革兰阴性菌感染患者腹水中MIP-1β浓度高于革兰阳性菌感染患者,差异有统计学意义(P<0.05)。结论血清和腹水中MIP-1β和PCT检测有助于鉴别诊断早期肝硬化失代偿期SBP,血清中PCT检测优于MIP-1β指标,腹水中MIP-1β检测优于PCT指标。Objective To invesngate the role of early.detecting macrophage inflammatory protein-1β（MIP-1β） and proealcitonin （PCT） level for the diagnosis of spontaneous bacterial peritonitis（SlAP） in the deeompensated stage of liver cirrhosis. Methods 384 cases of decompensated stage of liver cirrhosis complicating SBP collected in the Affiliated 3201 Hospital of Xi ＇an Jiaotong University from May 2011 to February 2015 were included into the SBP group ;while other 377 cases of decompensated stage of liver cirrhosis complicating ascites were included into the control group. The serum and ascites samples were collected for detecting PCT by using electrochemical luminescence method and MIP-1β by using the enzyme-linked immunoassay. The significance of these two in- dicators was compared between the serum detection and ascites detection. At the same time the clinical application value of these two indicators was analyzed by using the receiver operating characteristic curve. Results The serum and ascites PCT and MIP-1β levels in the SBP group were significantly higher than those in the control group, the difference was statistically significant （P〈0.05） ;the serum PCT level in the SBP group had statistical difference between .the patients with Gram-negative bacteria infection and the patients with Gram positive bacteria infection（P〈0.05） ;the ascites MIP-1β level in the patients with Gram-negative bacte- ria infection of the SBP group was higher than that with Gram positive bacteria infection,the difference was statistically significant （P〈0.05）. Conclusion The serum and ascites PCT and MIP-1β detection can help to the differentiation diagnosis of early decoin- pensated stage of liver cirrhosis complicating SBP;the serum PCT detection is superior to the MIP-1β detection,while ascites MIP 1β detection is superior to the PCT detection.

关 键 词：降钙素原 巨噬细胞炎性蛋白-1β 自发性细菌性腹膜炎 肝硬化失代偿期 

分 类 号：R575.2[医药卫生—消化系统]