血浆PCT NLR及MCP-1指标检测对肝硬化合并细菌性腹膜炎患者的诊断及预后评估价值

doi:10.3969/j.issn.1006-6233.2020.08.016

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Abstract Objective: To investigate the detection of plasma procalcitonin (PCT), neutrophil-to-lymphocyte ratio (NLR) and monocyte chemotactic protein-1 (MCP-1) in the diagnosis of liver cirrhosis with spontaneous bacterial peritonitis (SBP) and the value of prognosis evaluation. Methods: A total of 146 patients with liver cirrhosis and ascites treated in our hospital from December 2017 to December 2018 were selected and divided into SBP group (n=76) and non-SBP group (n=70) according to clinical manifestations and laboratory examination results. Another 51 healthy examinees in the same period in our hospital were randomly selected as control group. The levels of plasma PCT, NLR and MCP-1 were measured among the three groups, and receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic value of PCT, NLR and MCP-1 on liver cirrhosis with SBP. The changes of plasma PCT, NLR and MCP-1 before and after treatment were analyzed in SBP group, and the value of PCT, NLR and MCP-1 in the prognosis evaluation of liver cirrhosis with SBP was investigated. Results: The levels of plasma PCT, NLR and MCP-1 in SBP group were significantly higher than those in non-SBP group and control group (P<0.05), and the level of plasma MCP-1 in non-SBP group was significantly higher than that in control group (P<0.05), and there were no significant differences in the PCT and NLR compared with those in control group (P>0.05). ROC curve results showed that when the optimal cutoff value of PCT was 0.94ng/ml, the AUC for diagnosis of liver cirrhosis with SBP was 0.850 (95% CI: 0.787-0.912), and when the optimal cutoff value of NLR was 13.72, the AUC was 0.721 (95% CI: 0.639-0.803), and when the optimal cutoff value of MCP-1 was 0.69μg/L, the AUC was 0.810 (95% CI: 0.741-0.879), and the AUC of combination of the three was 0.866 (95% CI: 0.807-0.926). The AUC, sensitivity and specificity of the combined diagnosis were better than those of PCT, NLR or MCP-1 alone. The levels of plasma PCT, NLR and MCP-1 in patients with liver cirrhosis and SBP after treatment were significantly lower than those before treatment (P<0.05). Conclusion: The levels of plasma PCT, NLR and MCP-1 are abnormally elevated in patients with liver cirrhosis and SBP. Detection of plasma PCT, NLR and MCP-1 has certain clinical value in the early diagnosis and prognosis evaluation of liver cirrhosis and SBP.

Key words： Procalcitonin Neutrophil-to-lymphocyte ratio Monocyte chemotactic protein-1 Liver cirrhosis Spontaneous bacterial peritonitis Value

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.08.016 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I8/1300

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