PT、s14和64在肝硬化并发自发性细菌性腹膜炎诊疗中的意义.docVIP

PCT、SCD14和CD64在肝硬化并发自发性细菌性腹膜炎诊疗中的意义 李春英1邹金海2梁育飞1 （1.河北省沧州市屮心医院消化内一科河北沧州061001） （2.沧州市屮心医院核医学科河北沧州061001） 】目的：检测肝硬化患者外周血及腹水降钙素原（PCT）、SCD14和 CD64的水平，探讨外周血及腹水PCT、SCD14和CD64检测对白发性细菌性腹膜 炎（SBP）的诊断价值。方法：将肝硬化患者分为肝硬化SBP组（30例组1）、肝 硬化腹水非SBP组（30例）（组2）及健康对照组（30例）（组3） 3组。应用电 化学发光免疫法测定血清、腹水降钙素原；应用流式细胞术测定外周血及腹水 CD64、SCD14。分别采集肝硬化SBP组患者在入院后24小时内、抗菌药物使用 前及抗生素有效治疗7d的空腹上肢静脉血及无菌腹水,测定患者体内PCT、sCD14 和CD64水平，同时行血常规、肝肾功能、凝血功能检查。肝硬化腹水非SBP组 及健康对照组一次性采血及抽腹水测定以上指标。结果:SBP组治疗前外周血PCT、 SCD14和CD64水平较腹水非SBP组和对照组明显升高，差异有统计学意义（P 0.01）,而腹水非SBP组和对照组间比较差异无统计学意义（P〉0.05）; SBP组 治疗前腹水PCT、SCD14和CD64水平较腹水非SBP组明显升高，差异有统计学 意义（P0.01）;治疗后肝硬化SBP组血及腹水PCT、SCD14和CD64水平明显卜 降，与治疗前比较差异有统计学意义（Plt;0.05;另SBP组治疗前后腹水屮PCT、 SCD14和CD64水平均明显高于外周血屮的水平,差异均有统计学意义（Plt;0.05）。 结论：血及腹水屮PCT、SCD14和CD64水平检测对于肝硬化SBP的早期诊断、 疗效判定有一定的临床意义；且腹水检测敏感度优于外周血检测。 关键词】肝硬化；降钙素原；SCD14； CD64；自发性细菌性腹膜炎 屮图分类号】R657.3+1 】B 】1003-5028 (2015) 8-0872-02 Clinical significance of PCT、sCD14 and CD64 in patients with cirrhosis and spontaneous bacterial peritonitis [Abstract] Objective： To detect the concentration of PCT,sCD14 and CD64 in blood and ascites and investigate the diagnosis value of PCT,sCD14 and CD64 in blood and ascites. Methods： There were three groups.The sixty patients with liver cirrhosis were divided into two groups.Liver cirrhosis with spontaneous bacterial peritonitis(SBP)(30 patients) were in group 1 and liver cirrhosis without SBP(30 patients) were in group 2.Thirty healthy subjects were in control group(group 3).The PCT in blood and ascites was detemined by electrochemiluminescence immunoassay(ECLI) and The sCD14 and CD64 in blood and ascites were determined by flow cytometry .The fasting venous blood in the upper limb and ascites were obtained from patients in group 1 at the time of within 24 hours after admission, before use of antibiotics and seven days after antibiotic effective treatment.The PCT,sCD14 and CD64 were detected and at the same time the blood count, liver, kidney and blood coagulate functions were tested.AII the same tes