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使用试剂条快速诊断自发性细菌性腹膜炎。

Rapid diagnosis of spontaneous bacterial peritonitis by use of reagent strips.

作者信息

Castellote José, López Carmen, Gornals Joan, Tremosa Gemma, Fariña Eva Rodríguez, Baliellas Carmen, Domingo Alicia, Xiol Xavier

机构信息

Servicio de Aparato Digestivo y Servicio de Hematología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Hepatology. 2003 Apr;37(4):893-6. doi: 10.1053/jhep.2003.50120.

Abstract

We studied the use of reagent strips for diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites. A reagent strip for leukocyte esterase designed for the testing of urine with a colorimetric 5-grade scale (0 to 4) was used to evaluate ascitic fluid in 228 nonselected paracentesis performed in 128 cirrhotic patients. We diagnosed 52 SBP and 5 secondary bacterial peritonitis by means of polymorphonuclear cell count and classical criteria. When we considered positive a reagent strip result of 3 or 4, sensitivity was 89% (51 of 57), specificity was 99% (170 of 171), and positive predictive value was 98%. When we considered positive a reagent strip result of 2 or more, sensitivity was 96% (55 of 57), specificity was 89% (152 of 171), and negative predictive value was 99%. In conclusion, the use of reagent strips is a rapid, easy to use, and inexpensive tool for diagnosis of ascitic fluid infection. A positive result should be an indication for empirical antibiotic therapy, and a negative result may be useful as a screening test to exclude SBP.

摘要

我们研究了试剂条在肝硬化腹水患者自发性细菌性腹膜炎(SBP)诊断中的应用。一种用于尿液检测的比色法5级刻度(0至4)白细胞酯酶试剂条,被用于评估128例肝硬化患者进行的228次非选择性腹腔穿刺抽取的腹水。我们通过多形核细胞计数和经典标准诊断出52例SBP和5例继发性细菌性腹膜炎。当我们将试剂条结果3或4视为阳性时,敏感性为89%(57例中的51例),特异性为99%(171例中的170例),阳性预测值为98%。当我们将试剂条结果2或更高视为阳性时,敏感性为96%(57例中的55例),特异性为89%(171例中的152例),阴性预测值为99%。总之,试剂条的使用是一种快速、易用且廉价的腹水感染诊断工具。阳性结果应作为经验性抗生素治疗的指征,阴性结果可作为排除SBP的筛查试验。

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