CAJ | 학술논문

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(P<0.05)；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,P<0.001)；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。
목적：탐토혈청강개소원검측재중증을간병발자발성세균성복막염진단중적의의。방법정군선취2011년2월—2014년12월재해원취진적만성중증을간환자142례,근거시부발생자발성세균성복막염분위병발조(n=61)화대조조(n=81),대소유연구대상혈청강개소원、C-반응단백수평화백세포계수진행검측,이용수시자공작특정곡선(ROC곡선)대불동지표진단효능진행분석。결과병발조조환자강개소원、C-반응단백수평화백세포계수균고우대조조,차이유통계학의의(P<0.05)；Pearson상관분석현시,혈청강개소원수평여백세포계수화C-반응단백수평균정정상관(r=0.360화0.851,P<0.001)；강개소원ROC곡선하면적0.943(95%CI：0.905~0.981),령민도86.9%,특이도87.7%；백세포계수ROC곡선하면적0.765(95%CI：0.687~0.842),령민도88.5%,특이도51.9%；C-반응단백ROC곡선하면적0.892(95%CI：0.827~0.956),령민도83.6%,특이도88.9%。결론중증을간병발자발성세균성복막염환자혈청강개소원수평승고,구유교고적진단효능,가작위환자조기진단적지표。
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 (P<0.05). 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 P<0.001). 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 for C- reactive protein, its area under the ROC curve 0.892 (95% CI:0.827 ~ 0.956), sensitivity 83.6%, specificity of 88.9%. Conclusion The level of serum procalcitonin for the patients with severe hepatitis B complicated with spontaneous bacterial peritonitis was elevated, and had a high diagnostic efficiency, which could be used as an index for patients’ early diagnosis.