白细胞酯酶试纸条检测对肝硬化患者自发性细菌性腹膜炎诊断的诊断效度

Diagnostic validity of leukocyte esterase dipstick test for diagnosis of spontaneous bacterial peritonitis in cirrhotic patients.

作者信息

Khatwani Nanik Ram, Chhutto Mumtaz Ali, Abro Hakim Ali, Shaikh Majid Ahmed

机构信息

Department of Medicine, Chandka Medical College Hospital, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2011 Jan-Mar;23(1):51-4.

PMID:22830146

Abstract

BACKGROUND

Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis (SBP) is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate, so early diagnosis and treatment of SBP is therefore necessary for survival. Leukocyte esterase dipstick test can rapidly diagnose the SBP. Objectives were to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis.

METHODS

This cross-sectional, validation study was conducted from January 2009 to June 2009 at Medical Unit-II, Chandka Medical College Hospital Larkana. All the Patients with cirrhosis and ascites of either gender were included in this study. Paracentesis were performed on admission. The ascitic fluid obtained at bedside was immediately tested with reagent strip Multistix 10 SG. Ascitic fluid was then analysed for PMN cell count. The result of reagent strip was compared with ascitic fluid PMN cell count for determination of sensitivity, specificity, PPV and NPV of the test, while taking ascitic fluid PMN count > or = 250/mm3 as standard for diagnosis of SBP. Leukocyte esterase dipstick read positive from +1 to +3 reaction while negative and trace reaction regarded as negative test result.

RESULTS

Total ninety four patients were enrolled in this study. Ninety-four Ascitic fluid samples were obtained. SBP was diagnosed in 52 (55.3%) patients, 42 (44.7%) patients were negative for SBP by manual cell count. The sensitivity, specificity, PPV, NPV of leukocyte esterase dipstick test to diagnose SBP were 92%, 95%, 96%, 90% respectively.

CONCLUSION

The leukocyte esterase dipstick test can be used as rapid test for diagnosis of SBP due to its high diagnostic validity.

摘要

背景

自发性细菌性腹膜炎（SBP）被定义为腹水感染且无明显的腹腔内可手术治疗的感染源。自发性细菌性腹膜炎（SBP）是肝硬化腹水患者的严重并发症之一。若不进行早期抗生素治疗，该并发症的死亡率很高，因此早期诊断和治疗SBP对于患者存活至关重要。白细胞酯酶试纸条检测可快速诊断SBP。目的是确定白细胞酯酶试纸条检测对自发性细菌性腹膜炎的诊断准确性。

方法

这项横断面验证研究于2009年1月至2009年6月在拉尔卡纳钱德卡医学院医院第二医疗单元进行。纳入所有肝硬化腹水的男女患者。入院时进行腹腔穿刺。在床边获取的腹水立即用尿十项试纸条（Multistix 10 SG）检测。然后分析腹水的中性粒细胞计数。将试纸条检测结果与腹水中性粒细胞计数进行比较，以确定该检测的敏感性、特异性、阳性预测值和阴性预测值，同时将腹水中性粒细胞计数≥250/mm³作为SBP的诊断标准。白细胞酯酶试纸条检测结果从+1到+3反应为阳性，而阴性和微量反应视为阴性检测结果。