临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
16期
1336-1339
,共4页
肝硬化%自发性细菌性腹膜炎%PCT%CD64指数%抗感染%预测作用
肝硬化%自髮性細菌性腹膜炎%PCT%CD64指數%抗感染%預測作用
간경화%자발성세균성복막염%PCT%CD64지수%항감염%예측작용
Liver cirrhosis%Spontaneous bacterial peritonitis%PCT%CD64 index%Anti infection%Prediction function
目的：研究降钙素原（PCT）联合 CD64平均荧光强度指数（CD64指数）在肝硬化合并自发性细菌性腹膜炎（SBP）患者抗感染治疗效果中的预测作用。方法选择2010年5月至2014年5月接受诊治的失代偿期的肝硬化腹水患者112例实施研究。依据患者临床表现及实验室检测结果将患者划分为非 SBP 组24例（阴性对照组）和疑似 SBP组70例，以及 SBP 确诊组18例。将疑似 SBP 组70例患者进一步划分亚组，分别是伴腹痛组30例，无腹痛组40例。外周血的中性粒细胞百分比上升组36例，外周血的中性粒细胞百分比未上升组34例。SBP 确诊组及疑似 SBP 组共88例经抗感染治疗后划分亚组，分别是治疗有效组59例和治疗无效组29例。对比各组实验室指标情况、疑似 SBP 组不同亚组的实验室指标情况、SBP 确诊组及疑似 SBP 组经抗感染治疗后不同效果亚组的实验室指标情况，分析 PCT 联合 CD64指数对患者治疗效果的预测作用。结果 SBP 确诊组、疑似 SBP 组及阳性对照组的腹水 CD64指数及外周血 PCT 水平均分别显著高于阴性对照组，同时，SBP 确诊组的腹水 CD64指数及外周血 PCT 水平均分别显著高于疑似 SBP 组，差异均有统计学意义（均 P ﹤0.05）。疑似 SBP 组下的伴腹痛组与无腹痛组在腹水 CD64指数、WBC 计数以及外周血 WBC和 PCT 指标水平上对比，差异无显著性。但外周血的中性粒细胞百分比上升组的腹水 CD64指数及外周血 PCT 水平均分别显著高于外周血的中性粒细胞百分比未上升组，差异均有统计学意义（均 P ﹤0.05）。治疗有效组的腹水 CD64指数及外周血 PCT 水平均分别显著低于治疗无效组，差异均有统计学意义（均 P ﹤0.05）。PCT 联合 CD64指数对患者治疗效果进行预测的灵敏度和准确性均高于两指标单独应用，特异度亦较好。结论 PCT 联合 CD64指数对肝硬化合并SBP 患者的抗感染疗效具有较好的预测作用，值得在临床上推广应用。
目的：研究降鈣素原（PCT）聯閤 CD64平均熒光彊度指數（CD64指數）在肝硬化閤併自髮性細菌性腹膜炎（SBP）患者抗感染治療效果中的預測作用。方法選擇2010年5月至2014年5月接受診治的失代償期的肝硬化腹水患者112例實施研究。依據患者臨床錶現及實驗室檢測結果將患者劃分為非 SBP 組24例（陰性對照組）和疑似 SBP組70例，以及 SBP 確診組18例。將疑似 SBP 組70例患者進一步劃分亞組，分彆是伴腹痛組30例，無腹痛組40例。外週血的中性粒細胞百分比上升組36例，外週血的中性粒細胞百分比未上升組34例。SBP 確診組及疑似 SBP 組共88例經抗感染治療後劃分亞組，分彆是治療有效組59例和治療無效組29例。對比各組實驗室指標情況、疑似 SBP 組不同亞組的實驗室指標情況、SBP 確診組及疑似 SBP 組經抗感染治療後不同效果亞組的實驗室指標情況，分析 PCT 聯閤 CD64指數對患者治療效果的預測作用。結果 SBP 確診組、疑似 SBP 組及暘性對照組的腹水 CD64指數及外週血 PCT 水平均分彆顯著高于陰性對照組，同時，SBP 確診組的腹水 CD64指數及外週血 PCT 水平均分彆顯著高于疑似 SBP 組，差異均有統計學意義（均 P ﹤0.05）。疑似 SBP 組下的伴腹痛組與無腹痛組在腹水 CD64指數、WBC 計數以及外週血 WBC和 PCT 指標水平上對比，差異無顯著性。但外週血的中性粒細胞百分比上升組的腹水 CD64指數及外週血 PCT 水平均分彆顯著高于外週血的中性粒細胞百分比未上升組，差異均有統計學意義（均 P ﹤0.05）。治療有效組的腹水 CD64指數及外週血 PCT 水平均分彆顯著低于治療無效組，差異均有統計學意義（均 P ﹤0.05）。PCT 聯閤 CD64指數對患者治療效果進行預測的靈敏度和準確性均高于兩指標單獨應用，特異度亦較好。結論 PCT 聯閤 CD64指數對肝硬化閤併SBP 患者的抗感染療效具有較好的預測作用，值得在臨床上推廣應用。
목적：연구강개소원（PCT）연합 CD64평균형광강도지수（CD64지수）재간경화합병자발성세균성복막염（SBP）환자항감염치료효과중적예측작용。방법선택2010년5월지2014년5월접수진치적실대상기적간경화복수환자112례실시연구。의거환자림상표현급실험실검측결과장환자화분위비 SBP 조24례（음성대조조）화의사 SBP조70례，이급 SBP 학진조18례。장의사 SBP 조70례환자진일보화분아조，분별시반복통조30례，무복통조40례。외주혈적중성립세포백분비상승조36례，외주혈적중성립세포백분비미상승조34례。SBP 학진조급의사 SBP 조공88례경항감염치료후화분아조，분별시치료유효조59례화치료무효조29례。대비각조실험실지표정황、의사 SBP 조불동아조적실험실지표정황、SBP 학진조급의사 SBP 조경항감염치료후불동효과아조적실험실지표정황，분석 PCT 연합 CD64지수대환자치료효과적예측작용。결과 SBP 학진조、의사 SBP 조급양성대조조적복수 CD64지수급외주혈 PCT 수평균분별현저고우음성대조조，동시，SBP 학진조적복수 CD64지수급외주혈 PCT 수평균분별현저고우의사 SBP 조，차이균유통계학의의（균 P ﹤0.05）。의사 SBP 조하적반복통조여무복통조재복수 CD64지수、WBC 계수이급외주혈 WBC화 PCT 지표수평상대비，차이무현저성。단외주혈적중성립세포백분비상승조적복수 CD64지수급외주혈 PCT 수평균분별현저고우외주혈적중성립세포백분비미상승조，차이균유통계학의의（균 P ﹤0.05）。치료유효조적복수 CD64지수급외주혈 PCT 수평균분별현저저우치료무효조，차이균유통계학의의（균 P ﹤0.05）。PCT 연합 CD64지수대환자치료효과진행예측적령민도화준학성균고우량지표단독응용，특이도역교호。결론 PCT 연합 CD64지수대간경화합병SBP 환자적항감염료효구유교호적예측작용，치득재림상상추엄응용。
Objective To study prediction function of anti infection treatment effect of PCT combined with CD64 index in patients with cir-rhosis combined with spontaneous bacterial peritonitis(SBP). Methods Between May 2010 to 2014,decompensated liver cirrhosis of 112 cases of ascites were included into the present implementation research. Based on the results of clinical manifestations and laboratory results,patients were di-vided into non SBP group 24 cases(control group)and 70 cases of suspected SBP group,and SBP group 18 cases diagnosed. The suspected SBP group of 70 patients was further divided sub group,respectively with abdominal pain group 30 cases,abdominal pain in 40 cases of group. Compared with the peripheral blood neutrophil percentage of group 36 cases,the peripheral blood neutrophil percentage did not increase in the group of 34 ca-ses. The diagnosis of SBP group and SBP group were 88 cases of suspected by anti infection treatment after the division of sub groups,respectively. The treatment was effective in the treatment group of 59 cases ,and the treatment of 29 cases was ineffective in other group. Groups were compared in laboratory index,index of laboratory conditions. For different subgroups of suspected SBP group,SBP group and SBP group were diagnosed by anti infection treatment effect after different subgroups of laboratory index,analysis of effect of PCT combined with CD64 index to predict the therapeutic effects. Results SBP diagnosis group,suspected ascitic CD64 index and PCT level in the peripheral blood of SBP group and positive control group were significantly higher than that of the negative control group. At the same time,the CD64 index of ascites and peripheral blood PCT level of SBP group was significantly higher than that diagnosed were suspected of SBP group. The differences were statistically significant(all P ﹤0. 05). The as-cites CD64 index,WBC and the number of peripheral blood WBC and PCT index level were compared between the suspected with abdominal pain group of the SBP group. The difference was not significant. But ascites CD64 index and peripheral blood PCT level in peripheral blood neutrophil per-centage rise group were significantly higher than that of peripheral blood neutrophil percentage did not rise group,the difference was statistically sig-nificant( P ﹤0. 05). Ascites CD64 index and the peripheral blood levels of PCT treatment group were significantly lower than that of the ineffective treatment group,the difference was statistically significant( P ﹤0. 05). PCT and CD64 index on the therapeutic effect of patients with predictive sensitivity and accuracy were the highest,the specificity was good. Conclusion PCT combined with CD64 index in cirrhotic patients has the forecast function. The larger SBP anti infection effect in patients with obvious effect,worth in clinical application.
