【摘要】 目的探讨血清降钙素原(PCT)、白介素-6(IL-6)及C反应蛋白(CRP)对乙型肝炎肝硬化并发自发性细菌性腹膜炎(SBP)的诊断价值。方法根据腹水性质,将我院住院的150例乙型肝炎肝硬化腹水患者分为SBP组90例,非SBP组60例,并选择同期健康体检者50例作为对照组,检测血清PCT、IL-6和CRP,利用ROC曲线分析PCT、IL-6和CRP对SBP的诊断价值。结果 1)血清PCT在SBP组、非SBP组、对照组分别为(0.78±0.59)ng/mL、(0.18±0.16)ng/mL、(0.05±0.03)ng/mL,SBP组高于非SBP组和对照组(P值均<0.05),非SBP组与对照组之间的差异无统计学意义(P>0.05)。2)血清IL-6及CRP在SBP组分别为(87.89±43.33)pg/mL及(40.53±31.98)mg/mL,非SBP组分别为(41.90±25.38)pg/mL及(13.29±11.33)mg/L,对照组分别为(5.23±12.13)pg/mL及(3.13±2.24)mg/L,SBP组血清IL-6及CRP均高于非SBP组和对照组(P值均<0.05),非SBP组血清IL-6及CRP亦高于对照组(P值均<0.05)。3)PCT在ROC曲线下面积为0.903,较IL-6及CRP在ROC曲线下面积大(分别为0.721及0.674)(P<0.05),而IL-6与CRP在ROC曲线下面积的差异无统计学意义(P>0.05);以PCT、IL-6和CRP作为诊断指标来判断SBP,最佳临界值分别为0.63ng/mL、72.58pg/mL和38.87mg/L,所对应的灵敏度分别为90.1%、83.4%和88.2%,特异度分别为82.9%、76.3%和67.5%。结论血清PCT、IL-6及CRP对乙型肝炎肝硬化并发SBP有一定的参考价值,而以PCT的诊断价值最大。更多还原

【Abstract】 Objective To investigate the diagnosis value of serum calcitonin(PCT),interleukin 6(IL-6)and C-reactive protein(CRP)in spontaneous bacterial peritonitis(SBP)complicated by hepatitis B virus-related cirrhosis.Methods A total of150 cases of hepatitis B virus-related cirrhosis and ascites were divided into two groups according to the nature of ascites(n=90with SBP and n=60without SBP),and 50 healthy individuals were analyzed as control group.The serum PCT,IL-6and CRP were detected.Receiver operating characteristic(ROC)curves were used to compare the diagnostic values of PCT,IL-6and CRP in SBP.Results 1)The serum PCT in SBP group [(0.78±0.59)ng/mL]was higher than that in non-SBP group[(0.18±0.16)ng/mL]and control group[(0.05±0.03)ng/mL](all P<0.05),and there were no significant differences between non-SBP group and control group.2)The serum IL-6and CRP in SBP group[(87.89±43.33)pg/mL and(40.53±31.98)mg/mL,respectively]were higher than those in non-SBP group[(41.90±25.38)pg/mL and(13.29±11.33)mg/L,respectively]and control group[(5.23±12.13)pg/mL and(3.13±2.24)mg/L,respectively](all P<0.05),the serum IL-6and CRP in non-SBP group were also higher than those in control group(all P<0.05).3)The area under the curve(AUC)for the serum PCT was 0.903 and bigger than that for the serum IL-6and CRP(0.721 and 0.674,respectively).Using cut-off points of 0.63ng/mL for PCT,72.58pg/mL for IL-6and 38.87 mg/L for CRP,the respective sensitivities for diagnosis of SBP were 90.1%,83.4% and 88.2%,and the respective specificities were 82.9%,76.3% and 67.5%.Conclusion Serum PCT seems to be better marker than IL-6and CRP for the diagnosis of hepatitis B virus-related cirrhosis patients with SBP.更多还原