首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2019年 6期 HBV cccDNA研究进展 => 肝纤维化及肝硬化 =>腹水中肝素结合蛋白及..
腹水中肝素结合蛋白及降钙素原对肝硬化腹水伴自发性细菌性腹膜炎的诊断价值
Value of heparin-binding protein in ascites and serum procalcitonin in diagnosis of spontaneous bacterial peritonitis
文章发布日期:2019年05月13日  来源:  作者:杨丽霞,张伦理,赖玲玲,等  点击次数:283次  下载次数:57次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的探讨腹水中的肝素结合蛋白(HBP)联合血清降钙素原(PCT)对自发性细菌性腹膜炎(SBP)的诊断价值。方法收集南昌大学第一附属医院2016年1月-2018年6月住院的腹水患者120例,分为肝硬化腹水伴SBP组(40例)、漏出性腹水组(40例)、癌性腹水组(20例)和结核性腹水组(20例),纳入患者全部进行腹水培养,测定并统计分析腹水多形核白细胞、腹水 HBP和血清 PCT水平。符合正态分布的计量资料两组间比较采用独立样本t检验;非正态分布数据多组间比较用Kruskal-Wallis H 检验,组间两两比较用Nemenyi 检验;腹水HBP、血清PCT诊断效能分析采用受试者工作特征(ROC)曲线分析,腹水HBP、血清PCT相关性采用Spearman分析。结果肝硬化腹水伴SBP组腹水HBP浓度及血清PCT浓度与其余3组(漏出性腹水组、癌性腹水组、结核性腹水组)比较均显著升高(P值均<0.05)。腹水细菌培养病原学阳性的不同菌种间腹水HBP 水平无差异,腹水细菌培养阳性与阴性患者的HBP水平差异无统计学意义[(58.59±36.23) ng/ml vs (63.61±32.54) ng/ml,t=1.763,P>0.05)。血清PCT诊断SBP的ROC曲线下面积为0.831,当取血清PCT诊断SBP的最佳临界值为0.62 ng/ml时,敏感度为86.3%,特异度为528%。腹水HBP诊断SBP的ROC 曲线下面积为0.962,当取诊断SBP的最佳临界值为23.54 ng/ml时,敏感度为92.3%,特异度为65.4%,腹水HBP与血清PCT之间具有高度相关性(r=0.776,P<0.05)。结论腹水HBP的检测在SBP的诊断中有较高的价值,与传统的血清PCT联合检测可提高SBP的诊断效能。
【Abstract】:ObjectiveTo investigate the value of heparin-binding protein (HBP) in ascites combined with serum procalcitonin (PCT) in the diagnosis of spontaneous bacterial peritonitis (SBP). MethodsA total of 120 patients with ascites who were hospitalized in our hospital from January 2016 to June 2018 were enrolled and divided into cirrhotic ascites+SBP group with 40 patients, leaky ascites group with 40 patients, malignant ascites group with 20 patients, and tuberculous ascites group with 20 patients. Bacterial culture of ascites was performed for all patients, and polymorphonuclear leukocyte (PMN) count in ascites, HBP in ascites, and serum PCT level were measured and analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between multiple groups; non-normally distributed continuous data were expressed as median [M (P25, P75)], and the Kruskal-Wallis H test was used for comparison between multiple groups and the Nemenyi test was used for comparison between two groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of HBP in ascites and serum PCT, and the Spearman correlation analysis was used to investigate the correlation between HBP in ascites and serum PCT. ResultsThe cirrhotic ascites+SBP group had significant increases in the levels of HBP in ascites and serum PCT compared with the leaky ascites group, the malignant ascites group, and the tuberculous ascites group (P<0.05). There was no significant difference in HBP level in ascites between patients with different bacteria determined by bacterial culture of ascites (P>0.05), and there was also no significant difference in HBP level in ascites between patients with positive or negative results of bacterial culture of ascites (58.59±36.23 ng/ml vs 63.61±3254 ng/ml, t=1.763,P>0.05). Serum PCT had an optimal cut-off value of 0.62 ng/ml in the diagnosis of SBP, with an area under the ROC curve of 0.831, a sensitivity of 86.3%, and a specificity of 52.8%. HBP in ascites had an optimal cut-off value of 23.54 ng/ml in the diagnosis of SBP, with an area under the ROC curve of 0.962, a sensitivity of 92.3%, and a specificity of 65.4%. Ascites HBP was highly correlated with serum PCT (r=0.776, P<0.05). ConclusionThe level of HBP in ascites has a high value in the diagnosis of SBP, and combined measurement of ascites HBP and serum PCT can improve the diagnostic efficiency of SBP.
【关键字】:肝硬化; 自发性细菌性腹膜炎; 腹水; 肝素结合蛋白; 降钙素原
【Key words】:liver cirrhosis; spontaneous bacterial peritonitis; ascites; heparin binding protein; procalcitonin
【引证本文】:YANG LX, ZHANG LL, LAI LL, et al. Value of heparin-binding protein in ascites and serum procalcitonin in diagnosis of spontaneous bacterial peritonitis[J]. J Clin Hepatol, 2019, 35(6): 1266-1269. (in Chinese)
杨丽霞, 张伦理, 赖玲玲, 等. 腹水中肝素结合蛋白及降钙素原对肝硬化腹水伴自发性细菌性腹膜炎的诊断价值[J]. 临床肝胆病杂志, 2019, 35(6): 1266-1269.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号