Wu Hongli, Chen Lin, Sun Yuefeng, Meng Chao, Hou Wei
Hongli Wu, Ph.D., Department of Clinical Laboratory Medicine, Tianjin Second People's Hospital, Tianjin, China.
Lin Chen Ph.D., Department of Clinical Laboratory Medicine, Tianjin Second People's Hospital, Tianjin, China.
Pak J Med Sci. 2016 Nov-Dec;32(6):1484-1488. doi: 10.12669/pjms.326.10995.
To determine the role of serum procalcitonin (PCT) and C-reactive protein (CRP) in predicting spontaneous bacterial peritonitis (SBP) in patients with advanced liver cirrhosis.
A total of 88 patients with advanced liver cirrhosis were enrolled for this study, which included 40 cases with SBP and 48 cases with CNNA. Bacterial cultures, ascitic fluid (AF) leukocyte, C-reactive protein (CRP) and serum PCT measurements were carried out prior to the use of antibiotics. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of procalcitonin levels.
Serum PCT levels in advanced liver cirrhotic patients with SBP were significantly higher than those with CNNA. We used PCT 0.78 ng/mL as optimal cutoff value to diagnose SBP, for which the sensitivity and specificity was 77.5% and 60.4%. The area under the curve (AUC) was 0.706 (95% confidence interval: 0.576-0.798). The PCT level was significantly correlated with the AF WBC count (rs=0.404, P<0.01). However, there was no significant difference between SBP and CNNA patients in serum CRP levels.
According to our findings, serum PCT levels seem to provide an early diagnostic accuracy in advanced liver cirrhotic patients with SBP.
确定血清降钙素原（PCT）和C反应蛋白（CRP）在预测晚期肝硬化患者自发性细菌性腹膜炎（SBP）中的作用。
本研究共纳入88例晚期肝硬化患者，其中包括40例SBP患者和48例非感染性腹水（CNNA）患者。在使用抗生素之前进行细菌培养、腹水（AF）白细胞计数、C反应蛋白（CRP）和血清PCT检测。采用受试者工作特征（ROC）曲线评估降钙素原水平的诊断性能。
晚期肝硬化合并SBP患者的血清PCT水平显著高于CNNA患者。我们将PCT 0.78 ng/mL作为诊断SBP的最佳临界值，其敏感性和特异性分别为77.5%和60.4%。曲线下面积（AUC）为0.706（95%置信区间：0.576 - 0.798）。PCT水平与AF白细胞计数显著相关（rs = 0.404，P < 0.01）。然而，SBP患者和CNNA患者的血清CRP水平无显著差异。
根据我们的研究结果，血清PCT水平似乎能为晚期肝硬化合并SBP患者提供早期诊断准确性。
