CAJ | 학술논문

目的：检测失代偿期肝硬化患者腹水CD64指数，探讨其在自发性细菌性腹膜炎（SBP）中的诊断价值。方法将失代偿期肝硬化伴腹水患者分为非SBP组、SBP疑诊组和SBP确诊组，并设阴性和阳性对照组（非SPB组、腹水细菌培养阳性组）；依据腹痛及外周血中性粒细胞百分比，将SBP疑诊组进一步分组，流式细胞术检测各组的腹水CD64指数；并比较抗菌药物治疗后腹水CD64指数的差异。分析腹水CD64指数、腹水WBC计数及降钙素原诊断SBP的效能。结果腹水CD64指数在SBP确诊组（179．39±65．56）及SBP疑诊组（115．49±58．42）高于非SBP组（26．88±26．05），差异有统计学意义（P＜0．01）。SBP疑诊伴腹痛组与无痛组腹水CD64指数差异无统计学意义（P＞0．05）。SBP疑诊伴外周血中性粒细胞百分比升高组较无外周血中性粒细胞百分比升高组腹水CD64指数水平明显升高（ P＜0．05）。治疗无效组的CD64指数水平明显高于治疗有效组（ P＜0．01）。腹水CD64指数曲线下面积大于降钙素原及腹水WBC计数，并具有较高的灵敏度及特异度。结论腹水CD64指数检测快捷，影响因素少，可为临床上诊断SBP提供一种新选择。
목적：검측실대상기간경화환자복수CD64지수，탐토기재자발성세균성복막염（SBP）중적진단개치。방법장실대상기간경화반복수환자분위비SBP조、SBP의진조화SBP학진조，병설음성화양성대조조（비SPB조、복수세균배양양성조）；의거복통급외주혈중성립세포백분비，장SBP의진조진일보분조，류식세포술검측각조적복수CD64지수；병비교항균약물치료후복수CD64지수적차이。분석복수CD64지수、복수WBC계수급강개소원진단SBP적효능。결과복수CD64지수재SBP학진조（179．39±65．56）급SBP의진조（115．49±58．42）고우비SBP조（26．88±26．05），차이유통계학의의（P＜0．01）。SBP의진반복통조여무통조복수CD64지수차이무통계학의의（P＞0．05）。SBP의진반외주혈중성립세포백분비승고조교무외주혈중성립세포백분비승고조복수CD64지수수평명현승고（ P＜0．05）。치료무효조적CD64지수수평명현고우치료유효조（ P＜0．01）。복수CD64지수곡선하면적대우강개소원급복수WBC계수，병구유교고적령민도급특이도。결론복수CD64지수검측쾌첩，영향인소소，가위림상상진단SBP제공일충신선택。
Objective To detect the ascites CD64 index of patients with decompensated cirrhosis ,and explore the value in the di-agnosis of spontaneous bacterial peritonitis (SBP) .Methods Decompensated cirrhosis with ascites patients were divided into non-SBP group ,SBP suspected group and SBP diagnosed group .Two control groups were composed of patients with ascites culture pos-itive and non-SPB group .SBP suspected group were further grouped according to abdominal pain and the percentage of peripheral blood neutrophils .The CD64 index was detected by flow cytometry .Compared the difference of ascites CD64 index after treatment , and analyzed diagnosis performance of procalcitonin in human peripheral blood and ascites white blood cell count of SBP .Results The level of the ascites CD64 index was significantly higher in SBP diagnosed group (179 .39 ± 65 .56)and SBP suspected group (115 .49 ± 58 .42)than that of non-SBP group(26 .88 ± 26 .05)(P<0 .01) .The differences of the ascites CD64 index between SBP suspected associated with abdominal pain group and SBP suspected associated with painless group was not statistically significant (P>0 .05) .The level of the ascites CD64 index in SBP suspected with percentage of peripheral blood neutrophils elevated group was increased significantly than non-elevated group(P<0 .05) .CD64 index level in effective treatment group was significantly lower than the ineffective treatment group(P<0 .01) .The area of the ascites CD64 index under the curve was greater than procalcitonin in human peripheral blood and ascites WBC count ,and had a higher sensitivity and specificity .Conclusion The detection process of the ascites CD64 index is fast and with less influential factors ,which provides a new choice for the clinical diagnosis of SBP .