血清降钙素原与血清淀粉样蛋白A和白细胞介素-8诊断肝硬化腹水感染的研究

Clinical values of serum PCT, SAA and IL-8 in the diagnosis of ascites infections in patients with cirrhosis

  • 摘要: 目的 探讨血清降钙素原(PCT)、血清淀粉样蛋白A(SAA)、白细胞介素-8(IL-8)诊断肝硬化腹水感染的临床价值研究,为肝硬化腹水感染的诊断提供参考。方法 选取医院2015年1月-2016年12月住院治疗的肝硬化腹水患者100例,根据患者是否发生腹水感染分为感染组32例与无感染组68例,入院后穿刺抽取腹水进行细菌培养,抽取外周静脉血检测血清PCT、SAA、IL-8。结果 100例患者腹水培养阳性32例,感染率32.00%,32例共培养出病原菌35株,其中革兰阳性菌23株占65.71%,革兰阴性菌12株占34.29%。感染组患者血清PCT、SAA、IL-8分别为(5.22±1.25)ng/ml、(35.51±8.12)mg/L、(18.49±3.40)pg/ml显著高于无感染组(0.17±0.18)ng/ml、(4.19±0.27)mg/L、(10.20±2.34)pg/ml(P<0.05);以腹水细菌培养阳性为金标准,血清PCT、SAA、IL-8用于诊断腹水感染的灵敏度分别为96.88%、93.75%、87.50%,特异度分别为88.24%、79.41%、82.35%,曲线下面积为0.924、0.912、0.903,准确率为91.00%、84.00%、84.00%。结论 血清PCT、SAA、IL-8在肝硬化患者腹水感染时会出现升高,用于腹水感染的辅助诊断有较高的灵敏度及特异度,对临床无明显腹水感染症状的患者如存在血清PCT、SAA、IL-8的升高,建议进行早期干预治疗。

     

    Abstract: OBJECTIVE To sinvestigate clinical values of serum procalcitonin(PCT), serum amyloid protein A(SAA) and interleukin-8(IL-8) in the diagnosis of ascites infections in patients with cirrhosis, so as to provide references for the diagnosis of ascites infection in patients with cirrhosis. METHODS A total of 100 cases of ascites patients with cirrhosis treated in the hospital from Jan. 2015 to Dec. 2016 were selected, and were divided into infection group(32 cases) and non-infection group(68 cases) according to whether the patient had ascites infections. After admission, the ascites was puncture extraction for bacterial culture, and the peripheral blood samples were drawn for detection of serum PCT, SAA and IL-8. RESULTS Among 100 cases of patients, 32 cases were germiculture positive in ascites, and the positive rate was 32.00%. Totally 35 strains of pathogenic bacteria were cultured in 32 cases of patients, including 23 strains of gram-positive bacteria(65.71%) and 12 strains of gram-negative bacteria(34.29%). The PCT, SAA and IL-8 of infection group were (5.22±1.25)ng/ml, (35.51±8.12)mg/L and (18.49±3.40)pg/ml, which were significantly higher than (0.17±0.18)ng/ml, (4.19±0.27)mg/L and (10.20±2.34)pg/ml of non-infection group (P<0.05).Using ascites germiculture positive as the gold standard, the sensitivities of serum PCT, SAA and IL-8 were 96.88%, 93.75% and 87.50% in the diagnosis of ascites infection, the specificities were 88.24%, 79.41% and 82.35%,AUC were 0.924, 0.912 and 0.903, and precisions were 91.00%,84.00% and 84.00%, respectively. CONCLUSION Serum PCT, SAA and IL-8 levels increase in the ascites infection in patients with cirrhosis, which has high sensitivity and specificity in the auxiliary diagnosis of ascites infections. For patients with no obvious symptoms of ascites infections, if the serum levels of PCT, SAA and IL-8 are incresed, early intervention should be recommended.

     

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