IL-6和CRP与PCT检测早期诊断腹膜透析感染性腹膜炎及预后的临床价值  

Clinical value of IL-6 combined with CRP and PCT in early diagnosis of infective peritonitis and prognosis of peritoneal dialysis patients

作　　者：周飞燕[1] 吴凌慧[1] 汤素华[1] 陈琴芬[1] ZHOU Fei-yan;WU Ling-hui;TANG Su-hua;CHEN Qin-fen(Lishui People's Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市人民医院肾内科,浙江丽水323000

出　　处：《中华医院感染学杂志》2020年第18期2772-2775,共4页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(2019958)。

摘　　要：目的探讨白介素-6(IL-6)和C-反应蛋白(CRP)与降钙素原(PCT)检测早期诊断腹膜透析患者感染性腹膜炎及预后的临床价值。方法选取2016年6月-2019年6月丽水市人民医院肾内科收治的进行腹膜透析患者共99例,根据是否发生感染性腹膜炎分为感染组33例和未感染组66例,比较两组患者IL-6、CRP、PCT水平差异,受试者工作特征(ROC)曲线分析上述指标诊断感染的灵敏度和特异度。结果感染组患者血清IL-6(31.17±14.95)ng/ml、CRP(25.33±7.48)mg/L、PCT(1.57±0.84)ng/ml水平较对照组显著升高(P<0.05);IL-6、CRP和PCT联合检测诊断感染性腹膜炎的特异度为90.43%、灵敏度为94.72%、ROC曲线下面积(AUC)为0.967均显著优于单个指标;治疗后好转组患者的血清IL-6(12.05±7.88)ng/ml、CRP(19.32±8.26)mg/L、PCT(0.43±0.22)ng/ml水平显著低于恶化组(P<0.05)。结论IL-6、CRP和PCT联合检测能够显著提高早期诊断感染性腹膜炎的特异度及灵敏度,并且血清IL-6、CRP、PCT水平越低,患者预后越好。OBJECTIVE To explore the clinical value of interleukin-6(IL-6)combined with C-reactive protein(CRP)and procalcitonin(PCT)in early diagnosis of infective peritonitis and prognosis of the peritoneal dialysis patients.METHODS A total of 99 patients who underwent peritoneal dialysis in nephrology department of Lishui People′s Hospital from Jun 2016 to Jun 2019 were enrolled in the study and divided into the infection group with 33 cases and the non-infection group with 66 cases according to the status of infection.The levels of IL-6,CRP and PCT were compared between the two groups of patients,and receiver operating characteristic(ROC)curve analysis was performed for the sensitivity and specificity of the above indexes in diagnosis of the infection.RESULTS The levels of serum IL-6,CRP and PCT of the infection group were respectively(31.17±14.95)ng/ml,(25.33±7.48)mg/L and(1.57±0.84)ng/ml,significantly higher than those of the control group(P<0.05).The specificity,sensitivity and area under ROC curve of the joint detection of IL-6,CRP and PCT were respectively 90.43%,94.72%and 0.967 in diagnosis of infective peritonitis,significantly better than that of each single index.The levels of serum IL-6,CRP and PCT of the improved group were respectively(12.05±7.88)ng/ml,(19.32±8.26)mg/L and(0.43±0.22)ng/ml after the treatment,significantly lower than those of the deteriorated group(P<0.05).CONCLUSION The joint detection of IL-6,CRP and PCT can significantly improve the specificity and sensitivity in early diagnosis of infective peritonitis;the lower the levels of serum IL-6,CRP and PCT are,the better the prognosis.

关 键 词：白细胞介素-6 C-反应蛋白 降钙素原 感染性腹膜炎 早期诊断 预后 

分 类 号：R459.5[医药卫生—治疗学]