Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease

Juan Zhang; Wei Sun; Wei Zhang; Xiaomei Xiang; Wenting Tan; Xiulin Hu; Like Wu; Guohong Deng

doi:10.16016/j.1000-5404.201702097

您当前的位置：

首页 >

文章列表页 >

Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease

更新时间：2026-01-09

- Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease
- Journal of Third Military Medical University Vol. 39, Issue 11, Pages: 1159-1164(2017)
- 作者机构：
- 作者简介：
- 基金信息：
  
  the Major Project for Clinical Scientific Research of Third Military Medical University(2012XLC05);the Clinical Program of Military Medicine and War Injury Treatment of Southwest Hospital(SWH2016JSTSYB-24)
- DOI：10.16016/j.1000-5404.201702097
  CLC：
- Received：20 February 2017，
  
  Published：15 June 2017
- 稿件说明：
移动端阅览
Juan Zhang, Wei Sun, Wei Zhang, et al. Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease[J]. Journal of Third Military Medical University, 2017, 39(11): 1159-1164.
DOI：

Juan Zhang, Wei Sun, Wei Zhang, et al. Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease[J]. Journal of Third Military Medical University, 2017, 39(11): 1159-1164. DOI： 10.16016/j.1000-5404.201702097.

摘要

Abstract

Objective

To investigate the diagnostic value of serum procalcitonin(PCT) and percentage of neutrophils(Neu%) in the prediction of spontaneous bacterial peritonitis(SBP) in liver disease.

Methods

A retrospective analysis was conducted on 130 ascites patients hospitalized in the Southwest Hospital from January 2014 to December 2016. Clinical data of their serum PCT assay

common laboratory test and culture of ascites were collected. There were 89 patients verified with SBP

including 10 cases(SBP1 group) with culture-positive and polymorphonuclear(PMN) cells ≥250×10

11(SBP2 group) with culture-positive and PMN cells

250×10

and 68(SBP3 group) with culture-negative but PMN ≥250×10

/L. The other 41 patients were assigned as non-infective ascites group. The PCT level

Neu% and ascites PMN count were compared among the 4 groups. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance of PCT level and Neu% for SBP.

Results

Culture positivity was determined in 12.8% of SBP patients with PMN≥250×10

/L. Serum PCT levels was significantly higher in the patients with positive bacterial culture in ascitic fluid compared to patients with negative culture [median(min-max): 4.51(1.54

8.46)

0.77(0.21

1.69)

0.05

]

. ROC analysis showed that the optimal cut-off values of PCT were 0.795

0.265 and 0.405 ng/mL

respectively in t

he diagnosis of SBP1

SBP2 and SPB3

with areas under curves(AUC) of 0.963

0.767 and 0.714

separately

sensitivities of 100.00%

90.00% and 62.30%

respectively

and specificities of 92.70%

63.40% and 80.50%. The optimal cut-off values of Neu% in the diagnosis of SBP1

SBP2 and SPB3 were 68.45%

62.65% and 65.00%

respectively

with AUC of 0.878

0.756 and 0.669

respectively. According to the cut-off value above

PCT and Neu% in the diagnosis of SBP1

SBP2 and SPB3

the AUC were 0.976

0.865 and 0.706

respectively.

Conclusion

Serum PCT level and Neu% are of early warning effect and diagnostic value for SBP. Different SBP types have different cut-off values. Comprehensive analysis can be carried out on the actual situation in clinical practice.

关键词

Keywords

references

Arvaniti V D'Amico G Fede G Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis Gastroenterology 2010 139 4 1246 1256 10.1053/j.gastro.2010.06.019 Arvaniti V, D'Amico G, Fede G, et al .Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis[J ] .Gastroenterology, 2010, 139(4): 1246-1256.DOI:10.1053/j.gastro.2010.06.019.

Mokdad A A Lopez A D Shahraz S Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis BMC Med 2014 12 145 10.1186/s12916-014-0145-y Mokdad A A, Lopez A D, Shahraz S, et al .Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis[J ] .BMC Med, 2014, 12: 145.DOI:10.1186/s12916-014-0145-y.

Wiest R Lawson M Geuking M Pathological bacterial translocation in liver cirrhosis J Hepatol 2014 60 1 197 209 10.1016/j.jhep.2013.07.044 Wiest R, Lawson M, Geuking M.Pathological bacterial translocation in liver cirrhosis[J].J Hepatol, 2014, 60(1): 197-209.DOI:10.1016/j.jhep.2013.07.044.

Santiago A Pozuelo M Poca M Alteration of the serum microbiome composition in cirrhotic patients with ascites Sci Rep 2016 6 25001 10.1038/srep25001 Santiago A, Pozuelo M, Poca M, et al .Alteration of the serum microbiome composition in cirrhotic patients with ascites[J ] .Sci Rep, 2016, 6: 25001.DOI:10.1038/srep25001.

Pedersen J S Bendtsen F Møller S Management of cirrhotic ascites Ther Adv Chronic Dis 2015 6 3 124 137 10.1177/2040622315580069 Pedersen J S, Bendtsen F, Møller S.Management of cirrhotic ascites[J].Ther Adv Chronic Dis, 2015, 6(3): 124-137.DOI:10.1177/2040622315580069.

Runyon B A Management of adult patients with ascites due to cirrhosis: an update Hepatology 2009 49 6 2087 2107 10.1002/hep.22853 Runyon B A.Management of adult patients with ascites due to cirrhosis: an update[J].Hepatology, 2009, 49(6): 2087-2107.DOI:10.1002/hep.22853.

Pere Ginès Paolo Angeli Kurt Lenz EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis J Hepatol 2010 53 3 397 417 10.1016/j.jhep.2010.05.004 Pere Ginès, Paolo Angeli, Kurt Lenz, et al .EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis[J ] .J Hepatol, 2010, 53(3): 397-417.DOI:10.1016/ j.jhep.2010.05.004.

Mostafa M S El-Seidi E A Kassem A M Detection of ascitic fluid infections in patients with liver cirrhosis and ascites Arab J Gastroenterol 2011 12 1 20 24 10.1016/j.ajg.2011.01.004 Mostafa M S, El-Seidi E A, Kassem A M, et al .Detection of ascitic fluid infections in patients with liver cirrhosis and ascites[J ] .Arab J Gastroenterol, 2011, 12(1): 20-24.DOI:10.1016/j.ajg.2011.01.004.

Perumalswami P V Schiano T D The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists Dig Dis Sci 2011 56 5 1266 1281 10.1007/s10620-011-1619-9 Perumalswami P V, Schiano T D.The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists[J].Dig Dis Sci, 2011, 56(5): 1266-1281.DOI:10.1007/s10620-011-1619-9.

Gendrel D Bohuon C Procalcitonin, a marker of bacterial infection Infection 1997 25 3 133 134 10.1007/bf02113598 Gendrel D, Bohuon C.Procalcitonin, a marker of bacterial infection[J].Infection, 1997, 25(3): 133-134.DOI:10.1007/bf02113598.

朱研张辉艳张长江慢性肝衰竭并发自发性细菌性腹膜炎诊断标准探讨第三军医大学学报 2011 33 21 2227 2229 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201107026 朱研, 张辉艳, 张长江, 等.慢性肝衰竭并发自发性细菌性腹膜炎诊断标准探讨[J].第三军医大学学报, 2011, 33(21):2227-2229.

Zhu Y Zhang H Y Zhang C J Diagnostic criteria for spontaneous bacterial peritonitis in patients with chronic liver failure J Third Mil Med Univ 2011 33 21 2227 2229 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201107026 Zhu Y, Zhang H Y, Zhang C J, et al .Diagnostic criteria for spontaneous bacterial peritonitis in patients with chronic liver failure[J ] .J Third Mil Med Univ, 2011, 33(21):2227-2229..

Cekin Y Cekin A H Duman A The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients Int J Med Sci 2013 10 10 1367 1374 10.7150/ijms.6014 Cekin Y, Cekin A H, Duman A, et al .The Role of Serum Procalcitonin Levels in Predicting Ascitic Fluid Infection in Hospitalized Cirrhotic and Non-cirrhotic Patients[J ] .Int J Med Sci, 2013, 10(10):1367-1374.DOI: 10.7150/ijms.6014.

Zou M X Zhou R R Wu W J The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis Am J Emerg Med 2012 30 9 1907 1914 10.1016/j.ajem.2012.04.004 Zou M X, Zhou R R, Wu W J, et al .The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis[J ] .Am J Emerg Med, 2012, 30(9): 1907-1914.DOI:10.1016/j.ajem.2012.04.004.

Fernández J Gustot T Management of bacterial infections in cirrhosis J Hepatol 2012 56 Suppl 1 S1 S12 10.1016/S0168-8278(12)60002-6 Fernández J, Gustot T.Management of bacterial infections in cirrhosis[J].J Hepatol, 2012, 56(Suppl 1): S1-S12.DOI:10.1016/S0168-8278(12)60002-6.

朱龙川朱萱血降钙素原和C-反应蛋白对肝硬化腹水非多形核细胞性自发性细菌性腹膜炎的诊断意义中华消化杂志 2016 36 3 161 166 10.3760/cma.j.issn.0254-1432.2016.03.004 朱龙川, 朱萱.血降钙素原和C-反应蛋白对肝硬化腹水非多形核细胞性自发性细菌性腹膜炎的诊断意义[J].中华消化杂志, 2016, 36(3): 161-166.DOI:10.3760/cma.j.issn.0254-1432.2016.03.004.

Zhu L C Zhu X Roles of serum procalcitonin and c-reactive protein in the diagnosis of nonneutrocytic ascitic spontaneous bacterial peritonitis in liver cirrhosis Chinese Journal of Digestion 2016 36 3 161 166 10.3760/cma.j.issn.0254-1432.2016.03.004 L C, Zhu X.Roles of serum procalcitonin and c-reactive protein in the diagnosis of nonneutrocytic ascitic spontaneous bacterial peritonitis in liver cirrhosis[J].Chinese Journal of Digestion, 2016, 36(3): 161-166.DOI:10.3760/cma.j.issn.0254-1432.2016.03.004.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa

Construction of a diagnostic model for chronic mountain sickness among young male migrants to high-altitude areas

Congenital inner ear deformity with spontaneous cerebrospinal fluid leakage: a case series report of 9 children

Application of Hess automatic screen recording system in diagnosis of acquired paralytic strabismus

Clinical significance of diagnosis and classification of ratio of hsa a_circ_0001708 to IKZF1 for pediatric B-ALI

Related Author

ZHENG Xipeng

PAN Huilin

WU Linyu

HOU Yongying

LIU Qin

MA Qiang

QIN Xiuyuan

LIU Kaijun

Related Institution

Department of Gastroenterology， Chongqing Key Laboratory of Precise Prevention and Treatment of Digestive Malignancies

Department of Pathology， Army Medical Center of PLA/Daping Hospital of Third Military Medical University， Chongqing

First Clinical College of Chongqing Medical University

Department of High Altitude Physiology and Pathology, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

Department of Medicine and Hygienic Equipment for High Altitude Region, Faculty of High Altitude Military Medicine， Army Medical University （Third Military Medical University）

⁰