降钙素原和脂多糖结合蛋白水平在肝硬化患者中的临床意义  

The clinical significance of procalcitonin and lipopolysaccharide binding protein levels in patients with liver cirrhosis

作　　者：郑红情[1] 张文源[1] 张阿利[1] 林荣海[1] ZHENG Hongqing;ZHANG Wenyuan;ZHANG Ali;LIN Ronghai(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University,Taizhou317000,China)

机构地区：[1]浙江省台州医院重症医学科,浙江台州317000

出　　处：《中国现代医生》2022年第1期1-3,13,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2020KY1031)。

摘　　要：目的 探讨肝硬化患者降钙素原和脂多糖结合蛋白水平及临床意义。方法 随机选取浙江省台州医院2019年5月至2020年4月收治的60例肝硬化患者,按照有无合并腹水感染分为感染组38例和非感染组22例,采用酶联免疫吸附法检测脂多糖结合蛋白,采用双抗夹心免疫化学发光法测定降钙素原,并将各组结果进行比较。结果 肝硬化患者的血清降钙素原和脂多糖结合蛋白水平均显著高于健康对照组(P<0.05),其中感染组患者的血清降钙素原和脂多糖结合蛋白显著高于非感染组,差异有统计学意义(P<0.05)。经过抗生素对症治疗48 h后,感染组患者血清降钙素原相较治疗前明显下降,差异有统计学意义(P<0.001),血清LBP较治疗前升高,差异无统计学意义(P>0.05)。感染组死亡13例,存活25例,死亡者血清降钙素原和脂多糖结合蛋白浓度显著高于存活者(P<0.001)。结论 血清降钙素原和脂多糖结合蛋白对肝硬化腹水感染的早期诊断、疗效观察和判断预后有一定的临床价值。Objective To explore the levels and clinical significance of procalcitonin and lipopolysaccharide binding protein in patients with liver cirrhosis.Methods A total of 60 patients with liver cirrhosis who were admitted to Taizhou Hospital of Zhejiang Province from May 2019 to April 2020 were randomly selected and divided into the infection group(38 cases)and the non-infected group(22 cases)according to the presence or absence of ascites infection.Enzyme-linked immunosorbent assay was used to detect lipopolysaccharide-binding protein.The double antibody sandwich immunochemiluminescence method was used to determine procalcitonin.The results of each group were compared and analyzed.Results The levels of serum procalcitonin and lipopolysaccharide binding protein in patients with liver cirrhosis were significantly higher than those in the healthy control group(P<0.05).And the serum levels of procalcitonin and lipopolysaccharide binding protein in the infected group were significantly higher than those in non-infected group,and the differences were statistically significant(P<0.05).After 48 hours of symptomatic treatment with antibiotics,the serum procalcitonin of the infected patients decreased significantly compared with that before treatment,with significant statistical significance(P<0.001),and serum LBP of the infected patients increased compared with that before treatment,with no statistical difference(P>0.05).In the infection group,13 cases died,and 25 cases survived.The serum procalcitonin and lipopolysaccharide binding protein concentrations in the death group were significantly higher than those in the survival group(P<0.001).Conclusion Serum procalcitonin and lipopolysaccharide-binding protein have certain clinical value in the early diagnosis,efficacy observation,and prognosis judgment of liver cirrhosis and ascites infection.

关 键 词：血清降钙素原 脂多糖结合蛋白 肝硬化 腹水感染 脂多糖 

分 类 号：R575.2[医药卫生—消化系统]