原发性胆汁性肝硬化的早期诊断运用  

Clinical value of inflammatory factors in early diagnosis of primary biliary cirrhosis with bacterial infection

作　　者：李建柱 周琛 王剑飞[1] Jian-Zhu Li;Chen Zhou;Jian-Fei Wang(Clinical Laboratory,Second Hospital of Tianjin Medical University,Tianjin 300210,China)

机构地区：[1]天津医科大学第二医院检验科,天津市300210

出　　处：《世界华人消化杂志》2018年第33期1927-1932,共6页World Chinese Journal of Digestology

摘　　要：目的探究分析原发性胆汁性肝硬化合并细菌感染患者体内降钙素原、中性粒细胞百分比及免疫球蛋白表达水平的变化情况,明确上述指标对合并感染患者早期诊断的临床价值.方法回顾性分析2014-03/2016-05天津医科大学第二医院收治的83例原发性胆汁性肝硬化患者病历资料,根据患者有无合并细菌感染将入组患者分为感染组(n=47)和未感染组(n=36),统计感染组患者控制感染前血清降钙素原(pre-infection serum procalcitonin,PCT)水平、中性粒细胞百分率(neutrophilpercentage,N%)、白细胞计数(whitebloodcellcount, WBC)及IgM、IgG等免疫球蛋白的表达情况.结果统计显示,感染组患者平均血清PCT水平显著高于未感染组2.99 ng/mL±1.48 ng/mL vs 0.11 ng/mL±0.05ng/mL(P <0.05),且感染组患者超半数血清PCT水平≥2 ng/mL;纳入N%、WBC及IgM、IgG等炎性指标的统计发现,感染组患者上述指标水平均显著高于正常范围,且与对照组具有明显差异,分别为84.52%±11.87%vs56.04%±8.15%、8.44×10~9/L±3.05×10~9/L vs3.10×10~9/L±1.29×10~9/L、7.33 g/L±2.82 g/L vs3.18 g/L±1.03 g/L、32.18 g/L±8.61 g/L vs18.09g/L±6.14g/L(均P <0.05);分析不同类型感染患者血清PCT水平、N%、WBC及IgM、IgG水平等炎性指标水平发现,上述指标比较均无明显差异(均P>0.05).结论原发性胆汁性肝硬化合并细菌感染患者血清PCT、N%、WBC水平均显著高于正常参考值,血清PCT水平对反应患者机体炎性水平具有重要价值,联合检测血清PCT、N%及WBC对合并感染患者早期临床诊断具有重要意义.AIMTo investigate the changes of procalcitonin, neutrophil percentage, and immunoglobulin expression in patients with primary biliary cirrhosis and bacterial infection, andto determine their clinical value in the early diagnosis of primary biliary cirrhosis with bacterial infection. METHODSThe medical records of 83 patients with primary biliary cirrhosis admitted to Second Hospital of Tianjin Medical University from March 2014 to May 2016 wereretrospectively analyzed. According to he presence or absence of bacterial infection, the patients were divided into an infected group （n = 47） and a non-infected group （n = 36）. Serum procalcitonin （PCT） levels, neutrophil percentage （N%）, white blood cell count （WBC）, and immunoglobulins such as IgM and IgG were tested and compared between the two groups.RESULTSStatistical analysis showed that the mean serum PCT level of the infected group was signifcantly higher thanthat of the uninfected group （2.99 ng/mL ± 1.48 ng/mL vs 0.11 ng/mL ± 0.05 ng/mL, P 〈 0.05）, and half of the patients in the infected group had a serum PCT level ≥ 2 ng/mL. Infammatory markers such as N%, WBC, IgM, and IgG in the infected group were significantly higher than the normal range and those of the control group（84.52% ± 11.87% vs 56.04% ± 8.15%, 8.44 × 10^9/L ± 3.05 × 10^9/L vs 3.10 × 10^9/L ± 1.29 × 10^9/L, 7.33 g/L ± 2.82 g/L vs 3.18 g/L ± 1.03 g/L, 32.18 g/L ± 8.61 g/L vs 18.09 g/L ± 6.14 g/L, P 〈 0.05 for all）. The levels of PCT,N%, WBC, IgM, and IgG in patients with different types of infection had no signifcant difference （P 〉 0.05）.CONCLUSIONSerum PCT, N%, and immunoglobulin levels in patients with primary biliary cirrhosis and bacterial infection are significantly higher than the normal reference value, and serum PCT level is of great value in assessing the inflammatory level of patients. Combined detection of serum PCT, N%, and immunoglobulin levels is of greatsignificance for the early diagnosis of primary biliary cirrhosis with bacteri

关 键 词：原发性胆汁性肝硬化 细菌感染 降钙素原 中性粒细胞百分比 免疫球蛋白 

分 类 号：R575.2[医药卫生—消化系统]