Mousa N, Besheer T, Abdel-Razik A, Hamed M, Deiab A G, Sheta T, Eldars W
a Tropical Medicine Department , Mansoura University , Mansoura , Egypt.
b Internal Medicine Department , Mansoura University , Mansoura , Egypt.
Br J Biomed Sci. 2018 Apr;75(2):71-75. doi: 10.1080/09674845.2017.1396706. Epub 2018 Feb 16.
Spontaneous bacterial peritonitis (SBP) is diagnosed by the presence of ≥250 polymorphonuclear neutrophils (PMN)/mm in the ascites and the absence of surgically treatable cause of intra-abdominal infection. Blood neutrophil lymphocytic ratio (NLR) is an inexpensive and simple test for inflammation. C-reactive protein (CRP) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of combined blood NLR and CRP as a non-invasive test for SBP diagnosis.
Blood NLR was calculated, and CRP value determined in 180 cirrhotic patients with ascites (126 with and 54 without SBP). Sensitivity and specificity of combined blood NLR and CRP values for SBP diagnosis were estimated by receiver operator characteristic curve.
Both blood NLR and CRP values were significantly higher in SBP (p < 0.001). For SBP diagnosis, a blood NLR of >2.89 had a sensitivity 80.3% and specificity 88.9%. CRP >11.3 mg/dL had a sensitivity 88.9% and specificity 92.6%. In logistic regression analysis, combined blood NLR and CRP had a sensitivity 95.1% and specificity 96.3% at the same cut off values.
Combined NLR and CRP could be used as a novel, simple, low-cost, non-invasive test for SBP diagnosis.
自发性细菌性腹膜炎（SBP）通过腹水中多形核中性粒细胞（PMN）≥250/mm且无外科可治疗的腹腔内感染病因来诊断。血液中性粒细胞淋巴细胞比值（NLR）是一种用于炎症检测的廉价且简单的检测方法。C反应蛋白（CRP）是一种用于多种疾病和病症的诊断及随访的炎症标志物。我们旨在评估联合检测血液NLR和CRP作为SBP诊断的非侵入性检测方法的临床实用性。
计算180例肝硬化腹水患者（126例有SBP，54例无SBP）的血液NLR并测定CRP值。通过受试者工作特征曲线评估联合血液NLR和CRP值对SBP诊断的敏感性和特异性。
SBP患者的血液NLR和CRP值均显著更高（p < 0.001）。对于SBP诊断，血液NLR>2.89时敏感性为80.3%，特异性为88.9%。CRP>11.3mg/dL时敏感性为88.9%，特异性为92.6%。在逻辑回归分析中，联合血液NLR和CRP在相同临界值时敏感性为95.1%，特异性为96.3%。
联合NLR和CRP可作为一种用于SBP诊断的新型、简单、低成本的非侵入性检测方法。
