摘要
目的探讨血清淀粉样蛋白A(serum amyloid a,SAA)、C反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)对肝硬化合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的诊断价值。方法回顾性选择2021年5月—2022年5月齐齐哈尔医学院附属第二医院收治的50例肝硬化腹水并发SBP患者作为观察组,同期50例肝硬化腹水非SBP患者作为对照组,收集所有纳入对象的PCT、CRP、SAA,比较观察组和对照组的PCT、CRP、SAA水平,采用受试者操作特征曲线(receiver operating characteristic,ROC)分析相关因素诊断肝硬化合并SBP的价值。结果观察组PCT、CRP、SAA水平分别为(0.55±0.13)ng/mL、(10.29±2.75)mg/L、(20.85±4.74)mg/L,均高于对照组的(0.35±0.07)ng/mL、(5.89±1.32)mg/L、(14.88±2.64)mg/L,差异均有统计学意义(P<0.05)。ROC曲线结果显示,PCT、CRP、SAA单独诊断肝硬化患者并发SBP的最佳截断值为0.465 ng/mL、8.600 mg/L、17.080 mg/L,PCT、CRP、SAA单独诊断及3者联合诊断对肝硬化腹水并发SBP患者均有诊断价值,以3者联合诊断的AUC、灵敏度、特异度最高,差异有统计学意义(P<0.05)。结论PCT、CRP、SAA对肝硬化合并SBP患者均具有一定的诊断价值,但3者联合诊断的价值最高,表明3者联合诊断可提高肝硬化合并SBP的诊断准确率,有助于肝硬化患者合并SBP的早发现、早诊疗。
Objective This study aims to evaluate the diagnostic efficacy of serum amyloid A(SAA),C-reactive protein(CRP),and procalcitonin(PCT)as biomarkers in patients with liver cirrhosis complicated by spontaneous bacterial peritonitis(SBP).Methods A retrospective analysis was conducted on 50 patients diagnosed with cirrhotic ascites complicated by spontaneous bacterial peritonitis(SBP),who were admitted to the Second Affiliated Hospital of Qiqihar Medical University between May 2021 and May 2022,serving as the observation cohort,and 50 patients with cirrhosis ascites without SBP during the same period were selected as the control group.The concentrations of PCT,CRP,and SAA were measured in all participants,and a comparative analysis was conducted between the observation group and the control group.Additionally,the diagnostic efficacy of these biomarkers was evaluated using receiver operating characteristic(ROC)curve analysis to assess their value in identifying liver cirrhosis associated with SBP.Results The observation group exhibited significantly elevated levels of PCT,CRP,and SAA,measured at(0.55±0.13)ng/mL,(10.29±2.75)mg/L,and(20.85±4.74)mg/L,respectively,compared to the control group,which showed levels of(0.35±0.07)ng/mL,(5.89±1.32)mg/L,and(14.88±2.64)mg/L(t=9.578,10.200,7.781,respectively;P<0.05).The ROC curve results showed that the optimal cut-off values of PCT,CRP,and SAA alone for diagnosing cirrhotic patients with concurrent SBP were 0.465 ng/mL,8.600 mg/L,and 17.080 mg/L,respectively.Both the individual diagnosis using PCT,CRP,or SAA and the combined diagnosis of the three markers had diagnostic value for cirrhotic patients with ascites and concurrent SBP.The combined diagnosis of the three markers exhibited the highest AUC,sensitivity,and specificity,with a statistically significant difference(P<0.05).Conclusion PCT,CRP,and SAA exhibit significant diagnostic utility for identifying liver cirrhosis complicated by SBP;however,their combined use demonstrates the highest diagnostic efficacy.This integrated approach enhances the accuracy of diagnosing SBP in cirrhotic patients,facilitating early detection,timely intervention,and improved clinical outcomes.
作者
赵雪松
任明
马远洋
代云峰
李昂
王文斌
ZHAO Xuesong;REN Ming;MA Yuanyang;DAI Yunfeng;LI Ang;WANG Wenbin(Department of Medical Laboratory,the Second Affiliated Hospital of Qiqihar Medical University,Qiqihar Heilongjiang 161000,China)
出处
《中国卫生标准管理》
2025年第16期105-108,共4页
China Health Standard Management
基金
中关村精准医学基金会临床课题研究项目(320.99.2021.0921.012)。
关键词
淀粉样蛋白A
C反应蛋白
降钙素原
肝硬化
自发性细菌性腹膜炎
诊断价值
serum amyloid a
C-reactive protein
procalcitonin
liver cirrhosis
spontaneous bacterial peritonitis
diagnostic value
