The guiding value of procalcitonin and C⁃reactive protein in ascites for early treatment of spontaneous bacterial peritonitis patients
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    Abstract:

    Objective:This study aims to investigate the value of procalcitonin(PCT) and C-reactive protein(CRP) in the early treatment of cirrhosis patients with suspected abdominal infection. Methods:One hundred and twenty eight cirrhotic patients whose ascites cell count results meet the diagnostic criteria of spontaneous bacterial peritonitis(SBP) were enrolled in this study. PCT and CRP in ascitic specimens were tested,and patients were divided into SBP group and non-SBP group according to the bacterial culture results of ascitic specimens. The correlation between PCT,CRP expression and the occurrence of SBP were analyzed;the difference of PCT and CRP expression in patients infected with gram-negative bacteria(G-) and gram-positive bacteria(G+)were compared. The ROC curve was used to find the cut-off value of PCT and CRP level in SBP diagnosis. According to cut-off values of PCT and CRP used as the treatment standard,128 patients were re-grouped and the accuracy of antibiotic treatment was analyzed. Results:PCT level was much lower in non-SBP group than in SBP group(P < 0.05),and there was no statistical difference in CRP level between non-SBP group and SBP group(P > 0.05). PCT level were higher in G- group than in G+ group(P < 0.05),and there was no statistical difference in CRP level between G- group and G+ group(P > 0.05). The area under the ROC curve of PCT and ROC were 0.670 and 0.684,the cut-off value were 0.290 ng/mL and 34.0 mg/L,respectively. Under the situation without inflammatory biomarkers supplied,with PCT>0.290 ng/mL and with CRP>34.0 mg/L,the accuracy of antibiotic therapy were 67.2%,88.6% and 81.6%,respectively. Conclusion:PCT and CRP detection can provide useful information for screening and diagnosing SBP in cirrhosis patients,and elevate the accuracy of antibiotic therapy.

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吉远辉,许红攀,宁明哲.腹水降钙素原、C反应蛋白对自发性细菌性腹膜炎患者早期治疗的指导价值[J].南京医科大学学报(自然科学版英文版),2019,(9):1323-1326.

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History
  • Received:December 30,2018
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  • Online: September 29,2019
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