摘要
目的探讨联合检测血清淀粉样蛋白A(serum amyloid A,SAA)、脂多糖(lipopolysaccharide,LPS)及降钙素原(procallcitonin,PCT)对肝硬化合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的临床诊断价值。方法选取2016年8月至2017年7月于本院确诊的肝硬化患者60例纳入对照组、肝硬化合并SBP患者60例纳入观察组,分别检测两组患者血清SAA、LPS及PCT水平,并探讨三者联合检测对鉴别诊断肝硬化合并SBP的临床价值。结果观察组患者血清SAA、LPS及PCT水平均显著高于对照组(P_均<0.05)。当血清SAA临界值为30.96 mg/ml时,诊断肝硬化合并SBP的灵敏度为76.84%,特异度为85.11%,ROC曲线下面积(AUC)为0.831;当血清LPS临界值为68.24 pg/ml时,诊断肝硬化合并SBP的灵敏度为72.71%,特异度为80.30%,AUC为0.779;当血清PCT临界值为0.48 ng/ml时,诊断肝硬化合并SBP的灵敏度为84.26%,特异度为81.59%,AUC为0.862;联合检测血清SAA、LPS及PCT诊断肝硬化合并SBP的灵敏度为91.64%,特异度为95.77%,AUC为0.938。结论肝硬化合并SBP患者血清SAA、LPS及PCT水平均显著高于单纯肝硬化患者,三者联合检测对于鉴别诊断肝硬化合并SBP具有较高的临床价值。
Objective To investigate the clinical value of combined detection of serum amyloid A(SAA),lipopolysaccharide(LPS)and procallcitonin(PCT)in the differential diagnosis of spontaneous bacterial peritonitis(SBP)in patients with cirrhosis.Method 60 patients with liver cirrhosis were embedded in observation group and 60 patients with liver cirrhosis complicated with SBP were embedded in control group in our hospital from August 2016 to July 2017.Serum levels of SAA,LPS and PCT were measured in the two groups to explore the clinical value of combined detection of the three indexes in differential diagnosis of liver cirrhosis complicated with SBP.Result Serum SAA,LPS and PCT levels of observation group were significantly higher than those of control group(Pall<0.05).When the critical value of serum SAA was 30.96 mg/ml,the sensitivity of diagnosis of liver cirrhosis combined with SBP was 76.84%,the specificity was 85.11%,the area under the curve(AUC)was 0.831;when the critical value of serum LPS was 68.24 pg/ml,the sensitivity of diagnosis of liver cirrhosis combined with SBP was 72.71%,the specificity was 80.30%,the AUC was 0.779;when the critical value of serum PCT was 0.48 ng/ml,the sensitivity of diagnosis of liver cirrhosis combined with SBP was 84.26%,the specificity was 81.59%,the AUC was 0.862;the sensitivity of combined detection of serum SAA,LPS and PCT in the diagnosis of liver cirrhosis combined with SBP was 91.64%,the specificity was 95.77%,the AUC was 0.938.Conclusion The levels of serum SAA,LPS and PCT in patients with cirrhosis combined with SBP are significantly higher than patients with simple liver cirrhosis.The combined detection of SAA,LPS and PCT has high clinical value in differential diagnosis of liver cirrhosis combined with SBP.
作者
陈祥飞
徐维田
程翌
陈小朋
范楷
CHEN Xiang-fei;XU Wei-tian;CHENG Yi;CHEN Xiao-peng;FAN Kai(Department of Gastroenterology,Wuhan General Hospitalof Chinese PLA,Wuhan 430070,China)
出处
《中国医学前沿杂志（电子版）》
2019年第1期91-94,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
