血清降钙素原检测在重症乙肝并发自发性细菌性腹膜炎诊断中的意义.docVIP

血清降钙素原检测在重症乙肝并发自发性细菌性腹膜炎诊断中的意义 　　[摘要] 目的 探讨血清降钙素原检测在重症乙肝并发自发性细菌性腹膜炎诊断中的意义。方法 整群选取2011年2月―2014年12月在该院就诊的慢性重症乙肝患者142例，根据是否发生自发性细菌性腹膜炎分为并发组（n=61）和对照组（n=81），对所有研究对象血清降钙素原、C-反应蛋白水平和白细胞计数进行检测，利用受试者工作特征曲线（ROC曲线）对不同指标诊断效能进行分析。 结果 并发组组患者降钙素原、C-反应蛋白水平和白细胞计数均高于对照组，差异有统计学意义（P0.05）；Pearson相关分析显示，血清降钙素原水平与白细胞计数和C-反应蛋白水平均呈正相关（r=0.360和0.851，P0.001）；降钙素原ROC曲线下面积0.943（95%CI：0.905～0.981），灵敏度86.9%，特异度87.7%；白细胞计数ROC曲线下面积0.765（95%CI：0.687～0.842），灵敏度88.5%，特异度51.9%；C-反应蛋白ROC曲线下面积0.892（95%CI：0.827～0.956），灵敏度83.6%，特异度88.9%。结论 重症乙肝并发自发性细菌性腹膜炎患者血清降钙素原水平升高，具有较高的诊断效能，可作为患者早期诊断的指标。 　　[关键词] 重症乙肝；自发性细菌性腹膜炎；降钙素原；诊断 　　[中图分类号] R7 [文献标识码] A [文章编号] 1674-0742（2015）08（b）-0017-03 　　[Abstract] Objective To investigate the significance of serum procalcitonin detection in the diagnosis of severe hepatitis B complicated with spontaneous bacterial peritonitis. Methods 142 patients with Chronic severe hepatitis B patients，which accepted in our hospital from February 2011 to December 2014， were selected， and according to the occurrence of spontaneous bacterial peritonitis divided into the complicated group （n = 61） and the control group （n = 81）， and then all research objects’ serum procalcitonin， C- reactive protein level and white blood cell count were detected， index diagnostic efficiency were analyzed with the receiver operating characteristic curve （ROC curve）. Results Concurrent group patients’ serum procalcitonin， C- reactive protein level and white blood cell count were higher than that of the control group， and the difference was statistically significant （P0.05）. Pearson correlation analysis showed that serum procalcitonin levels， white blood cell count and C- reactive protein levels were positively correlated （r = 0.360 and 0.851， both P0.001）. For serum procalcitonin， its area under the ROC curve 0.943 （95% CI： 0.905 ～ 0.981）， sensitivity 86.9%， specificity 87.7%； for white blood cell count， its area under the ROC curve 0.765 （95% CI： 0.687 ～ 0.842）， sensitivity 88.5%， specificity 51.9%； and f