贵州医科大学学报

2016, v.41;No.192(09) 1092-1095

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血清降钙素原在肝硬化并发自发性细菌性腹膜炎中的诊断及预后价值
The Value of Serum PCT in Diagnosis and Prognosis of Liver Cirrhosis Complicated with Spontaneous Bacterial Peritonitis

赵世民;苏小青;高春燕;侯静芳;严志涵;
ZHAO Shimin;SU Xiaoqing;GAO Chunyan;HOU Jingfang;YAN Zhihan;Department of Gastroenterology,Xi'an Daxing Hspital;Huangling County People's Hospital;the First Hospital of Xi'an;Department of Liver Disease,Wuxi City Fifth People's Hospital;

摘要(Abstract):

目的:探讨血清降钙素原(PCT)在肝硬化并发自发性细菌性腹膜炎(SBP)中的诊断及判断预后价值。方法:120例肝硬化患者,根据是否并发SBP分为并发SBP组和肝硬化组,肝硬化组采取利尿、保肝常规基础支持治疗,并发SBP组在肝硬化组患者的治疗基础上进行抗感染治疗,比较两组治疗12 d时的治疗效果,采用酶联免疫法检测两组患者入院第1、2、3、4、5、7及9天时血清PCT水平,比较入院第1天时两组患者血清PCT水平,同时比较并发SBP组患者中死亡病例与存活病例血清PCT变化情况。结果:并发SBP组患者死亡率明显高于肝硬化组(P<0.05);入院第1天时肝硬化组患者血清PCT水平均在正常值内,并发SBP组有54例患者(90%)PCT高于正常值;并发SBP组患者入院第1、2、3、4、5、7及9天的血清PCT含量均显著高于肝硬化组(P<0.05),两组患者的血清PCT水平均于第4天达到峰值,之后均逐渐下降;并发SBP组中死亡病例在入院第1、2、3、4、5、7及9天时的血清PCT含量均显著高于存活病例(P<0.05),且均于第4天是达峰值,存活病例之后均逐渐下降,而死亡病例则一直保持较高水平。结论:血清PCT测定可做作为肝硬化并发SBP的诊断和判断预后的指标。
Objective: To explore the application value of serum calcitonin in the diagnosis and prognosis of liver cirrhosis complicated with spontaneous bacterial peritonitis( SBP). Methods: According to whether the patients were complicated with SBP,120 cases of patients with liver cirrhosis diagnosed in our hospital were selected and divided into two groups,with 60 patients complicated with SBP being observation group while 60 patients not complicated with SBP patients being control group. The control group received diuretic treatment and routine liver protecting therapy while the observation group received anti-infective therapy based on the therapy for the control group. The therapeutic effect of was compared between the two group after 12 day treatment. ELISA was adopted to detect serum PCT level of patients at 1st,2nd,3rd,4th,5th,7thday after admission to the hospital. The serum PCT level of patients at 1stday was compared between the two groups. At the same time,the changes of serum PCTwere compared between death cases and survival cases in the observation group. Results: The patient mortality in observation group was significantly higher than that in control group( P < 0. 05). At 1st day after admission,the serum PCT levels of the control were within the normal value,while the serum PCT levels of 54 patients( 90%) in observation group were higher than the normal value. The serum PCT levels in observation group at 1st,2nd,3rd,4th,5th,7thday after admission were significantly higher than those in control group( P < 0. 05),and at 4thday reached the highest value. The serum PCT levels declined gradually in survival cases but kept a relatively high level in death cases. Conclusion: Serum PCT determination can be used as an indicator and diagnosis and prognosis of liver cirrhosis complicated with SBP.

关键词(KeyWords): 血清降钙素原;肝硬化;腹膜炎,自发性,细菌性;酶联免疫吸附法;预后
serum calcitonin;liver cirrhosis;peritonitis;spontaneous;bacterial;enzyme linked immunosorbent assay;prognosis

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基金项目(Foundation): 南京医科大学科技发展基金项目(2013NJMU197)

作者(Author): 赵世民;苏小青;高春燕;侯静芳;严志涵;
ZHAO Shimin;SU Xiaoqing;GAO Chunyan;HOU Jingfang;YAN Zhihan;Department of Gastroenterology,Xi'an Daxing Hspital;Huangling County People's Hospital;the First Hospital of Xi'an;Department of Liver Disease,Wuxi City Fifth People's Hospital;

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