Dr Indrajit Kumar Datta. Associate Professor, Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders, BIRDEM General Hospital, Dhaka, Bangladesh; E-mail: E-mail:
Mymensingh Med J. 2023 Oct;32(4):1163-1168.
The role of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in the diagnosis of spontaneous bacterial peritonitis (SBP) with decompensated chronic liver disease (CLD) has been a subject of debate. The purpose of this cross-sectional, observational study was to evaluate the significance of CRP and PCT for the diagnosis and prediction of SBP in decompensated CLD patients. Fifty patients with ascites due to decompensated CLD were enrolled conveniently from the department of Gastrointestinal, Hepatobiliary and Pancreatic disorders (GHPD), BIRDEM General Hospital, Bangladesh from July 2019 to July 2020. Of these decompensated CLD patients with SBP were enrolled as the case group and without SBP as control group. Diagnostic and predictive value of PCT and CRP were calculated using the different statistical analysis. Among 50 patients, SBP was diagnosed in 9 patients (18.0%). The ROC analysis results yielded that the optimum cut off value for PCT was 0.67ng/ml and sensitivity, specificity, positive predictive value, negative predictive value, accuracy, AUC were 88.9%, 90.2%, 66.6%, 97.3, 90%, 0.947 respectively. On the contrary the optimum cut off value for CRP was 57.4mg/L and sensitivity, specificity, positive predictive value, negative predictive value, accuracy, AUC were 77.8%, 85.4%, 53.8%, 94.5%, 84%, 0.859 respectively. Our results indicate that the value of serum PCT and CRP were reliable to diagnose SBP in ascites due to decompensated CLD. Serum PCT and CRP level measurements may provide an early good diagnostic test for SBP in decompensated CLD patients.
血清降钙素原（PCT）和 C 反应蛋白（CRP）水平在诊断失代偿性慢性肝病（CLD）并发自发性细菌性腹膜炎（SBP）中的作用一直存在争议。本横断面观察性研究的目的是评估 CRP 和 PCT 对失代偿性 CLD 患者 SBP 诊断和预测的意义。2019 年 7 月至 2020 年 7 月，我们从孟加拉国 BIRDEM 总医院胃肠肝胆胰腺科（GHPD）方便地招募了 50 名因失代偿性 CLD 导致腹水的患者。这些失代偿性 CLD 患者中，有 SBP 的患者被纳入病例组，没有 SBP 的患者被纳入对照组。使用不同的统计分析方法计算 PCT 和 CRP 的诊断和预测价值。在 50 名患者中，诊断出 9 名（18.0%）患者患有 SBP。ROC 分析结果表明，PCT 的最佳截断值为 0.67ng/ml，其敏感性、特异性、阳性预测值、阴性预测值、准确性和 AUC 分别为 88.9%、90.2%、66.6%、97.3%、90%和 0.947。相反，CRP 的最佳截断值为 57.4mg/L，其敏感性、特异性、阳性预测值、阴性预测值、准确性和 AUC 分别为 77.8%、85.4%、53.8%、94.5%、84%和 0.859。我们的结果表明，血清 PCT 和 CRP 值可可靠地诊断失代偿性 CLD 并发腹水的 SBP。血清 PCT 和 CRP 水平测量可能为失代偿性 CLD 患者 SBP 提供早期良好的诊断试验。
