PGRN/Alb、sTREM-1、LBP指标诊断肝硬化细菌性腹膜炎价值及对疗效影响  

The value of PGRN/Alb,sTREM-1 and LBP in the diagnosis of spontaneous bacterial peritonitis in liver cirrhosis and their influence on the therapeutic effect

作　　者：公建庄[1] 杜晨旭 吴慧丽[1] GONG Jianzhuang;DU Chenxu;WU Huili(Department of Gastroenterology,Zhengzhou Central Hospital,Zhengzhou,Henan,China,450006;Department of Clinical Laboratory,Zhengzhou Central Hospital,Zhengzhou,Henan,China,450006)

机构地区：[1]郑州市中心医院消化内科,河南郑州450006 [2]郑州市中心医院检验科,河南郑州450006

出　　处：《分子诊断与治疗杂志》2021年第9期1410-1413,1418,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(LHG20191055)。

摘　　要：目的探讨颗粒蛋白前体与血清白蛋白比值(PGRN/Alb)、可溶性髓样细胞触发受体-1(sTREM-1)、脂多糖结合蛋白(LBP)指标诊断肝硬化细菌性腹膜炎(SBP)价值及对疗效影响。方法选取2018年1月至2019年1月郑州市中心医院收治的142例肝硬化患者,根据是否并发SBP分为SBP组(n=46)、无SBP组(n=96),并选取同期46例健康体检人群作为对照组。比较3组基线资料、PGRN/Alb、sTREM-1、LBP水平,采用多因素Logistic回归方程、受试者工作特征曲线(ROC)、ROC下面积(AUC)、Spearman分析处理数据。结果高脂血症发生率比较:无SBP组>对照组>SBP组,差异有统计意义(P<0.05);糖尿病发生率、PGRN/Alb、sTREM-1、LBP比较:SBP组>无SBP组>对照组,差异有统计意义(P<0.05)。将高脂血症、糖尿病控制后,PGRN/Alb、sTREM-1、LBP仍与SBP发生相关(P<0.05)。ROC曲线显示PGRN/Alb+sTREM-1+LBP联合诊断SBP的AUC为0.928,优于单一诊断(P<0.05)。不同疗效患者PGRN/Alb、sTREM-1、LBP水平比较:无效组>有效组>显效组,差异有统计学意义(P<0.05)。Spearman进行相关性分析,结果显示,PGRN/Alb(r=-0.807,P<0.001)、sTREM-1(r=-0.726,P<0.001)、LBP(r=-0.706,P<0.001)与疗效呈负相关。结论 PGRN/Alb、sTREM-1、LBP不仅能作为诊断SBP的生物标志物,并能评估患者对抗菌治疗的反应性,为临床诊治SBP提供可靠的参考。Objective To investigate the value of the ratio of progranulin to serum albumin(PGRN/Alb),soluble myeloid cell trigger receptor-1(sTREM-1),lipopolysaccharide binding protein(LBP)in the diagnose of cirrhotic bacterial peritonitis(SBP) value and impact on efficacy.Methods A total of 142 patients with liver cirrhosis admitted to Zhengzhou Central Hospital from January 2018 to January 2019 were divided into the SBP group(n=46) and the non-SBP group(n=96) according to whether they were complicated by SBP,and 46 healthy people during the same period were selected as the control group.The baseline data,PGRN/Alb,sTREM-1, and LBP levels among the three groups were compared,and the data were analyzed and processed by multivariate Logistic regression equation,receiver operating characteristic curve(ROC),area under ROC(AUC),and Spearman.Results Comparison of the incidence of hyperlipidemia:the non-SBP group> the control group> the SBP group,the difference was statistically significant(P<0.05).Comparison of diabetes incidence,PGRN/Alb,sTREM-1,LBP:the SBP group>the non-SBP group>the control group,the difference was statistically significant(P<0.05).After controlling hyperlipidemia and diabetes,PGRN/Alb,sTREM-1,and LBP were still related to the occurrence of SBP(P<0.05).The ROC curve showed that the AUC of PGRN/Alb+sTREM-1+LBP combined diagnosis of SBP was 0.928,which was better than single diagnosis(P<0.05).Comparison of the levels of PGRN/Alb,sTREM-1,and LBP in patients with different curative effects:the ineffective group>the effective group>the significantly effective group,the difference was statistically significant(P<0.05).Spearman analysis showed that PGRN/Alb(r=-0.807,P<0.001),sTREM-1(r=-0.726,P<0.001),LBP(r=-0.706,P<0.001) were negatively corrected with the efficacy.Conclusion PGRN/Alb,sTREM-1,and LBP can be used as biomarkers for the diagnosis of SBP,and evaluate the patient’s response to antibacterial therapy,providing a reliable reference for the clinical diagnosis and treatment of SBP.

关 键 词：PGRN/Alb STREM-1 LBP 肝硬化 细菌性腹膜炎 

分 类 号：R575.2[医药卫生—消化系统]