血清降钙素原水平作为肝炎后肝硬化患者腹水感染的早期标志物的作用。

The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients.

机构信息

Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.

Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt.

出版信息

Antiinflamm Antiallergy Agents Med Chem. 2021;20(1):61-67. doi: 10.2174/1871523019666200303104932.

DOI:10.2174/1871523019666200303104932

PMID:32124702

Abstract

AIMS & BACKGROUND: The early diagnosis of spontaneous bacterial peritonitis (SBP) has been considered important in the overall patient's survival. Ascitic fluid culture examination performance, in the emergency setting, is time-consuming and not always available, so there is a need for easy to apply, rapid and reliable markers for diagnosis of patients with ascites. The present prospective study aimed to determine the early diagnostic value of serum procalcitonin (PCT) levels in decompensated cirrhotic patients (DCPs) with SBP.

METHODS

47 HCV cirrhotic patients with ascites were enrolled for this prospective study. The severity of cirrhosis was classified based on the Child-Pugh criteria. All patients were subjected to paracentesis and ascitic fluid (AF) culture. Serum PCT levels were measured using enzyme-linked fluorescence analysis (ELFA).

RESULTS

The diagnostic value of serum PCT levels and WBC/PLT ratios for detecting infections were serum PCT levels (3.63 ± 3.47 ng/mL) in DCPs with infections which were significantly higher than in DCPs without infections (0.505 ± 0.230 ng/mL); p < 0.05. The cut-off value for serum PCT levels was 0.7 ng/mL for the diagnosis of infections in DCPs, for which the sensitivity and specificity were 93.1% and 73.2%, respectively. The AUC was 0.91 (95% CI: 0.83-0.99).

CONCLUSION

Serum procalcitonin seems to provide satisfactory diagnostic biomarkers in SBP.

摘要

目的和背景

自发性细菌性腹膜炎（SBP）的早期诊断被认为对患者的整体生存至关重要。在急诊环境中，腹水培养检查的表现既费时又并非总是可用，因此需要易于应用、快速和可靠的标志物来诊断腹水患者。本前瞻性研究旨在确定血清降钙素原（PCT）水平在失代偿性肝硬化患者（DCP）合并 SBP 中的早期诊断价值。

方法

本前瞻性研究纳入了 47 例 HCV 肝硬化伴腹水的患者。根据 Child-Pugh 标准对肝硬化的严重程度进行分类。所有患者均接受了经皮穿刺抽腹水术和腹水（AF）培养。使用酶联荧光分析（ELFA）测量血清 PCT 水平。

结果

血清 PCT 水平和 WBC/PLT 比值对感染的诊断价值为感染的 DCP 患者的血清 PCT 水平（3.63 ± 3.47 ng/mL）明显高于无感染的 DCP 患者（0.505 ± 0.230 ng/mL）；p < 0.05。血清 PCT 水平的截断值为 0.7 ng/mL，用于诊断 DCP 中的感染，其灵敏度和特异性分别为 93.1%和 73.2%。AUC 为 0.91（95%CI：0.83-0.99）。