摘要
目的探讨肝硬化并发自发性细菌性腹膜炎(Spontaneous bacterial peritonitis,SBP)患者血清中颗粒蛋白前体水平及其在疾病诊断和预后评估中的价值。方法选择温岭市第一人民医院2016年1月-2017年12月肝硬化并发SBP患者96例作为肝硬化并发SBP组,肝硬化未并发SBP患者96例作为肝硬化组,同期96名健康体检者作为对照组。测定血清颗粒蛋白前体、C-反应蛋白、降钙素原水平。结果肝硬化并发SBP组血清颗粒蛋白前体、C-反应蛋白、降钙素原水平[(72.15±7.58)μg/L、(14.86±2.65)mg/L、(1.42±0.08)ng/ml]均高于对照组和肝硬化组(P<0.05),肝硬化组C反应蛋白水平[(7.48±1.52)mg/L]高于对照组(P<0.05),肝硬化组和对照组颗粒蛋白前体和降钙素原水平比较差异无统计学意义。肝硬化并发SBP组患者血清颗粒蛋白前体水平与C-反应蛋白、降钙素原呈正相关(r=0.597、0.653,P<0.05)。血清颗粒蛋白前体诊断肝硬化并发SBP的截断值为63.28μg/L,ROC曲线下面积为0.817,灵敏度为88.92%,特异度为91.43%。肝硬化并发SBP存活者和死亡者不同时间血清颗粒蛋白前体水平比较差异有统计学意义(P<0.001),时间和分组之间血清颗粒蛋白前体水平有交互作用(P<0.001),两组之间血清颗粒蛋白前体水平比较差异有统计学意义(P<0.001)。结论肝硬化并发SBP患者血清颗粒蛋白前体水平升高,颗粒蛋白前体水平在肝硬化并发SBP患者的诊断及预后评估中具有潜在价值。
OBJECTIVE To investigate the serum granule protein precursor levels in cirrhosis patients complicated with spontaneous bacterial peritonitis(SBP)and its value in disease diagnosis and prognosis evaluation.METHODS All the subjects in this study were enrolled in Wenling First People’s Hospital from January 2016 to December 2017.Totally 96 cirrhosis patients complicated with SBP were enrolled as the cirrhosis with SBP group,96 cirrhosis patients without SBP were enrolled as the cirrhosis group and 96 healthy subjects were enrolled as the control group.The levels of serum granule protein precursor,C-reactive protein and procalcitonin were measured.RESULTS The concentration of serum granule protein precursor(72.15±7.5)μg/L,C-reactive protein(14.86±2.65)mg/L and procalcitonin(1.42±0.08)ng/ml in the cirrhosis complicated with SBP group were significantly higher than those in the control group and the cirrhosis group(P<0.05).The level of C-reactive protein in the cirrhosis group(7.48±1.52)mg/L was significantly higher than that in the control group(P<0.05).There were no significant difference in granule protein precursor and procalcitonin levels between the cirrhosis group and the control group.The serum granule protein precursor level in patients with cirrhosis complicated with SBP was positively correlated with C-reactive protein and procalcitonin(r=0.597,0.653,P<0.05).Based on the ROC curve,the area under the ROC curve was 0.817,the sensitivity of the serum granule protein precursor was found to be 88.92%and the specificity 91.43%,and a cut off value above 63.28μg/L was defined as the diagnosis of cirrhosis with SBP.There were significant differences in serum granule protein precursor levels between survivors group and deaths group in different hospital days(P<0.001).There were an interaction of serum granule protein precursor levels between the days in hospital and groups(P<0.001).And there were statistically significant difference in serum granule protein precursor levels between the two groups(P<0.001).CONCLUSION The level of serum granule protein precursor in patients with cirrhosis complicated with SBP is elevated.The level of granule protein precursor has potential value in the diagnosis and prognosis evaluation of patients with cirrhosis complicated with SBP.
作者
彭官清
凌乔
潘沛沛
毛锦超
刘杰
PENG Guan-qing;LING Qiao;PAN Pei-pei;MAO Jin-chao;LIU Jie(Wenling First People's Hospital,Wenling,Zhejiang 317500,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第23期3558-3562,共5页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生一般研究计划基金资助项目(2016KYA009)
关键词
肝硬化
自发性细菌性腹膜炎
颗粒蛋白前体
诊断
预后
Cirrhosis
Spontaneous bacterial peritonitis
Granule protein precursor
Diagnosis
Prognosis
