血清CRP、LPS及血清/腹水蛋白梯度对SBP的鉴别诊断价值

目的 :探讨检测血清C反应蛋白(CRP)、内毒素(LPS)及血清/腹水蛋白梯度值鉴别诊断自发性腹膜炎(SBP)患者的临床价值.方法 :选取本院消化内科2013年2月~2014年1月收治60例肝硬化腹水合并SBP患者作为(SBP)组,60例年龄、性别相匹配的肝硬化单纯腹水患者作为对照组,检测两组患者血清CRP、LPS及血清/腹水蛋白梯度值等指标并进行分析.结果 :SBP组患者与对照组患者的ALT、AST、TBIL、ALB、PA、TC、PT测定值差异均无统计学意义;SBP组患者的CRP、LPS水平显著的高于对照组,SBP组患者的SAAG水平显著的低于对照组患者;CRP鉴别诊断肝硬化腹水合并SBP的临界值为16.00 mg/L,LPS的临界值为8.55 pg/ml,SAAG的临界值为20.86g/L;CRP+LPS+SAAG三者联合应用诊断肝硬化腹水合并SBP患者的ROC曲线下面积AUC值为0.918,诊断灵敏度为87.29%、特异度为93.06%.结论 :CRP、LPS及SAAG三者联合应用对于鉴别诊断肝硬化腹水合并SBP患者具有较高的临床价值.

The differential diagnostic value of serum CRP,LPS and serum / ascites protein gradient in SBP

Objective To investigate the clinical value of detecting serum C reactive protein (CRP), endotoxin (LPS) and differential diagnosis of spontaneous bacterial peritonitis (SBP). Methods Select hospital Gastroenterology February 2013 -January 2014 were treated 60 cases of liver cirrhosis patients with SBP as (SBP) group, 60 cases of age and sex-matched cir-rhotic patients with ascites alone as a control group, the patients were detected serum CRP, LPS and serum / ascites protein gradient value and other indicators and analyzed. Results ALT SBP patients and control patients, AST, TBIL, ALB, PA, TC, PT measured values were not significantly different; SBP group of patients with CRP, LPS levels significantly higher, SAAG level SBP group were significantly lower than the control patients; CRP differential diagnosis of hepatic cirrhosis complicated with SBP critical value 16.00 mg / L, LPS critical value 8.55 pg / ml, SAAG critical value 20.86g / L; CRP + LPS + SAAG three combined liver cirrhosis at diagnosis in patients with SBP ROC curve AUC value of 0.918, the diagnostic sensitivity of 87.29%and a specificity of 93.06%. Conclusion CRP, LPS and SAAG three joint application for the differential diagnosis of hepatic cirrhosis complicated with SBP in patients with high clinical value.