C反应蛋白、降钙素原检测在肝硬化自发性细菌性腹膜炎诊断中的意义

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目的检测肝硬化患者的C反应蛋白(CRP)、血清降钙素原(PCT)水平,探讨CRP、PCT检测对自发性细菌性腹膜炎(SBP)的诊断价值。方法 130例肝硬化患者,依据病情分为合并SBP组(80例)和腹水非SBP组(50例),另选50例健康体检者作为对照组。采集合并SBP组患者在抗菌药物使用前的空腹静脉血,测定血清CRP、PCT水平,同时行血常规、肝功能检查及腹水细菌培养和药敏试验。腹水非SBP组及对照组一次性采血测定以上血液学指标。结果培养合并SBP组腹水细菌结果显示:腹水细菌培养结果为大肠埃希菌20例,检出率最高;鲍曼不动杆菌9例,肺炎克雷伯菌8例,金黄色葡萄球菌8例,肠球菌属10例。合并SBP组血清CRP、PCT水平明显高于对照组和腹水非SBP组,差异具有统计学意义(P<0.01)。对照组与腹水非SBP组的血清CRP、PCT水平比较,差异无统计学意义(P>0.05)。肝硬化的SBP诊断中CRP及PCT水平的意义:以CRP>3.3 mg/L为阳性,以PCT>0.5μg/L为阳性。结论 CRP、PCT可作为肝硬化SBP早期诊断的重要指标。 Objective To detect the levels of C-reactive protein (CRP) and procalcitonin (PCT) in cirrhotic patients and to evaluate the diagnostic value of CRP and PCT in the detection of spontaneous bacterial peritonitis (SBP). Methods One hundred and thirty patients with cirrhosis were divided into SBP group (80 cases) and non-SBP group (50 cases) according to their condition, and 50 healthy subjects were selected as control group. Fasting venous blood was collected before combined use of antimicrobial agents in patients with SBP. Serum levels of CRP and PCT were measured. Blood tests, liver function tests, ascites bacterial culture and drug susceptibility tests were also performed. Ascites non-SBP group and control group one-time blood test for the above hematological indicators. Results Ascites bacterial culture in combined SBP group showed that 20 cases of Escherichia coli were cultured in ascites with the highest detection rate, 9 cases of Acinetobacter baumannii, 8 cases of Klebsiella pneumoniae, 8 cases of Staphylococcus aureus, Enterococcus 10 cases. The levels of serum CRP and PCT in the combined SBP group were significantly higher than those in the control group and non-SBP group (P <0.01). There was no significant difference in serum CRP and PCT between control group and ascites non-SBP group (P> 0.05). Significance of CRP and PCT levels in the diagnosis of cirrhosis SBP: Positive for CRP> 3.3 mg / L and positive for PCT> 0.5 μg / L. Conclusion CRP, PCT can be used as an important indicator of early diagnosis of liver cirrhosis SBP.
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