腹水降钙素原及乳铁蛋白在肝硬化合并自发性腹膜炎中的临床价值研究  

Clinical Value of Ascitic Fluid Calcitoninogen and Lactoferrin in Cirrhosis Combined with Spontaneous Peritonitis

作　　者：崔小玲[1] 黄义泽[1] 蔡文婕 袁园[2] 谭祝利 CUI Xiaoling;HUANG Yize;CAI Wenjie;YUAN Yuan;TAN Zhuli(Department of Infectious Diseases,Tongling People's Hospital,Tongling,Anhui Province,244000 China;Department of Laboratory,Tongling People's Hospital,Tongling,Anhui Province,244000 China;Department of Gastroenterology,Tongling People's Hospital,Tongling,Anhui Province,244000 China)

机构地区：[1]安徽省铜陵市人民医院感染疾病科,安徽铜陵244000 [2]安徽省铜陵市人民医院检验科,安徽铜陵244000 [3]安徽省铜陵市人民医院消化内科,安徽铜陵244000

出　　处：《系统医学》2022年第24期59-62,71,共5页Systems Medicine

基　　金：铜陵市卫健委科研项目(卫科研〔2018〕4号)。

摘　　要：目的探讨腹水降钙素原(procalcitonin,PCT)及乳铁蛋白(lactoferrin,LF)在肝硬化合并自发性腹膜炎(spontaneous bacterial peritonitis,SBP)中的临床价值。方法选择2018年5月—2021年12月期间入住安徽省铜陵市人民医院感染疾病科及消化内科的失代偿期肝硬化并腹水患者42例为研究对象,将22例合并SBP患者列为SBP组,20例未合并SBP患者列为非SBP组,分别检测两组患者血白细胞计数、中性粒细胞计数、CRP及腹水PCT、乳铁蛋白(LF)水平。采用ROC曲线评价各指标对SBP的诊断价值。结果SBP组患者血白细胞计数(7.67±2.57)×10^(9)个/L高于非SBP组(4.94±1.86)×10^(9)个/L、中性粒细胞计数(11.50±2.14)×10^(9)个/L高于非SBP组(4.50±1.05)×10^(9)个/L、CRP(12.47±2.21)mg/L高于非SBP组(3.27±1.05)mg/L、PCT(8.56±1.22)ng/mL高于非SBP组(1.55±0.38)ng/mL、LF(161.23±23.11)ng/mL高于非SBP组(78.21±10.22)ng/mL,差异有统计学意义(t=3.909、13.241、16.946、25.644、14.791,P<0.001)。腹水PCT、LF的AUC依次为0.703、0.724,联合检测AUC最大为0.896,显著高于单独检测的AUC。PCT、LF最佳临界值分别为0.48、201.45 ng/mL,对SBP的诊断灵敏度分别72.73%、77.27%,两者联合后的灵敏度95.45%高于单项检测,差异有统计学意义(P<0.05)。结论腹水PCT、LF联合检测对肝硬化合并SBP有早期诊断价值,为疾病的临床评估提供依据。Objective To investigate the clinical value of ascites procalcitonin(PCT)and lactoferrin(LF)in cirrhosis combined with spontaneous peritonitis(SBP).Methods 42 decompensated cirrhosis with ascites patients admitted to the Department of Infectious Diseases and the Department of Gastroenterology of the Tongling People's Hospital,Anhui Province from May 2018 to December 2021 were selected as study subjects.22 patients with combined SBP were classified as the SBP group and 20 patients without combined SBP were classified as the non-SBP group.The white blood cell count,neutrophil count,CRP,ascites PCT and lactoferrin(LF)levels were measured in the two groups.The ROC curve was used to evaluate the diagnostic value of each index for SBP.Results The blood leukocyte count(7.67±2.57)×10^(9)/L in the SBP group was higher than(4.94±1.86)×10^(9)/L in the non-SBP group,and the neutrophil count(11.50±2.14)×10^(9)/L was higher than(4.50±1.05)×10^(9)/L in the non-SBP group,CRP(12.47±2.21)mg/L was higher than(3.27±1.05)mg/L of the non-SBP group,PCT(8.56±1.22)ng/mL was higher than(1.55±0.38)ng/mL of non-SBP group,and LF(161.23±23.11)ng/mL was higher than that of non-SBP group(78.21±10.22)ng/mL,and the differences were statistically significant(t=3.909,13.241,16.946,25.644,14.791,P<0.001).The AUCs of ascites PCT and LF were 0.703 and 0.724,respectively,and the AUC of the combined test was the largest,which was 0.896,it was significantly higher than AUC detected separately.The best critical values of PCT and LF were 0.48 ng/mL and 201.45 ng/mL,respectively,and the diagnostic sensitivity of SBP was 72.73%and 77.27%,respectively,and the sensitivity of the combined test was 95.45%higher than that of the single test,the differences were statistically significant(P<0.05).Conclusion The combined test of PCT and LF in ascites has early diagnostic value for cirrhosis combined with SBP and provides a basis for clinical evaluation of the disease.

关 键 词：自发性腹膜炎 降钙素原 乳铁蛋白 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]