血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义

张娟; 孙伟; 张维; 向小梅; 谭文婷; 胡秀林; 吴力克; 邓国宏

doi:10.16016/j.1000-5404.201702097

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血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义

临床医学 | 更新时间：2026-01-09

- 血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义
- Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease
- 第三军医大学学报 2017年39卷第11期页码：1159-1164
- 作者机构：
- 作者简介：
- 基金信息：
  
  第三军医大学科研临床重大专项(2012XLC05);西南医院军事医学与战创伤救治临床新技术计划(SWH2016JSTSYB-24)
- DOI：10.16016/j.1000-5404.201702097
  中图分类号：
- 收稿：2017-02-20，
  
  纸质出版：2017-06-15
- 稿件说明：
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张娟, 孙伟, 张维, 等. 血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义[J]. 第三军医大学学报, 2017,39(11):1159-1164.

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.
张娟, 孙伟, 张维, 等. 血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义[J]. 第三军医大学学报, 2017,39(11):1159-1164. DOI： 10.16016/j.1000-5404.201702097.

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

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