血清PCT、CRP和IL-6联合检测在肝硬化合并腹水感染的诊断研究  

Diagnostic value of serum PCT,CRP and IL-6 in patients with cirrhosis complicated with ascites

作　　者：屈洁 王聪[1] 郝小康 刘亨元 QU Jie;WANG Cong;HAO Xiaokang;LIU Hengyuan(Department of Clinical Laboratory, the First Affiliated Hospital of Medical College of Xi＇an Jiao Tong University , Xi＇an , Shannxi 710061, China;Department of Clinical Laboratory , the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine ,Xianyang, Shannxi 712000, China;the Biochemistry Laboratory of the Golden Domain Medical Laboratory of Xi＇an, Xi ＇an, Shaanxi 710018, China)

机构地区：[1]西安交通大学医学院第一附属医院检验科,西安710061 [2]陕西中医药大学第二附属医院检验科,陕西咸阳712000 [3]西安金域医学检验所生化室,西安710018

出　　处：《检验医学与临床》2018年第10期1414-1417,共4页Laboratory Medicine and Clinic

摘　　要：目的探究血清降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素-6(IL-6)联合检测对肝硬化合并腹水感染患者的诊断价值。方法选取2014年5月至2016年6月该院80例肝硬化合并腹水感染患者(肝硬化腹水感染组)和80例单纯肝硬化患者(单纯肝硬化组),另选取同期健康者80例作为健康对照组。检测所有研究对象的血清PCT、CRP、IL-6水平,采用受试者工作特征(ROC)曲线分析单项指标,以及联合指标检测对肝硬化合并腹水感染患者的诊断价值。结果肝硬化合并腹水感染组患者血清PCT、CRP、IL-6水平均明显高于其他2组,差异有统计学意义(P<0.05);与健康对照组比较,单纯肝硬化组患者血清PCT水平较高,但差异无统计学意义(P>0.05),但血清CRP、IL-6水平较高,差异有统计学意义(P<0.05)。ROC曲线对PCT、CRP、IL-6单独检测对肝硬化合并腹水感染的诊断价值分析,PCT、CRP、IL-6单独检测的ROC曲线下面积(AUC)分别是0.751、0.599、0.627,组间比较差异有统计学意义(P<0.05)。IL-6+CRP、PCT+CRP、PCT+IL-6、PCT+IL-6+CRP联合检测的AUC分别是0.764、0.797、0.848、0.908;3项指标联合检测的灵敏度为96.9%,诊断符合率为90.8%,阳性预测值为0.941,阴性预测值为0.889。结论血清PCT、CRP、IL-6等指标均能对肝硬化合并腹水感染作出诊断,单项指标以PCT的诊断价值最高。3项指标联合检测可显著提高肝硬化合并腹水感染的灵敏度,同时也能弥补单项指标诊断率不高的缺点,对疾病的早期诊断及预后具有重要的临床意义。Objective To investigate the diagnostic value of serum procalcitonin（PCT）,C-reactive protein（CRP）and interleukin-6（IL-6）in patients with cirrhosis complicated with ascites infection.Methods A total of 80 patients with cirrhosis complicated with ascites and 80 patients with cirrhosis without ascites were enrolled in our hospital from May 2014 to June 2016,and 80 healthy subjects were selected as the control group.The levels of procalcitonin,C-reactive protein and interleukin-6 in the serum of the two groups were measured.The diagnostic value of ROC curve analysis and combined index was used to detect the patients with cirrhosis complicated with ascites.Results The levels of serum PCT,CRP and IL-6 in patients with cirrhosis and ascites were significantly higher than those in non-infected group and control group（P〈0.05）.Compared with the control group（P〈0.05）,while the levels of serum CRP and IL-6 were higher（P〈0.05）,but there was no significant difference between the two groups（P〈0.05）.The area under the ROC curve（AUC）of PCT,CRP and IL-6 in serum was 0.751,0.599 and 0.627,respectively.The diagnostic value of PCT,CRP and IL-6 alone in the detection of ascites infection in cirrhosis was analyzed by ROC curve.And the difference was statistically significant（P〈0.05）.The area under the ROC curve of detection of IL-6＋CRP,PCT＋CRP,PCT＋IL-6 and PCT＋IL-6＋CRP in serum was 0.764,0.797,0.848,0.908 respectively.The sensitivity was96.9%,the coincidence rate was 90.8%,the positive predictive value was 0.941,and the negative predictive value was 0.889.Conclusion Serum PCT,CRP and IL-6 indicators can diagnose cirrhosis and ascites infection,but the diagnostic value of PCT is the highest in single index.The combined detection of serum PCT,CRP and IL-6 can significantly improve the detection sensitivity of ascites infection in cirrhosis,and can also compensate the shortcomings of single serum index for the diagnosis of cirrhosis and ascites infection.The early diagnosis of diseas

关 键 词：肝硬化 腹水感染 降钙素原 C反应蛋白 白细胞介素-6 

分 类 号：R446[医药卫生—诊断学]