摘要
目的探究外周血中性粒细胞CD64和血清纤维蛋白原(FIB)对肝硬化腹水患者并发自发性细菌性腹膜炎(SBP)的诊断价值。方法选择2021年6月至2022年11月石家庄平安医院收治的60例肝硬化腹水并发SBP患者纳入SBP组,另选择60例同期无SBP的肝硬化腹水患者纳入非SBP组。收集入组患者的性别、年龄、BMI、肝硬化病因、实验室检查指标,以及入院时症状和体征等基本资料。采用多因素logistic回归模型分析影响肝硬化腹水患者并发SBP的危险因素。采用ROC曲线分析中性粒细胞CD64、血清FIB及两者联合检测对肝硬化腹水患者并发SBP的诊断价值。结果SBP组中性粒细胞CD64的表达水平显著高于非SBP组,血清FIB的表达水平显著低于非SBP组,差异均有统计学意义(P均<0.05)。单因素分析结果显示,SBP组中腹痛和发热患者占比,以及ALT、白细胞计数(WBC)水平均显著高于非SBP组,差异均有统计学意义(P均<0.05)。多因素logistic回归模型分析结果显示,发热、中性粒细胞CD64是肝硬化腹水患者并发SBP的危险因素,血清FIB则是保护因素(P均<0.05)。ROC曲线分析结果显示,中性粒细胞CD64联合血清FIB诊断肝硬化腹水患者并发SBP的曲线下面积(AUC)为0.965,均显著大于两者单独诊断(ZCD64=2.214,P=0.027;ZFIB=3.941,P=0.000)。结论肝硬化腹水并发SBP患者中性粒细胞CD64表达水平升高,血清FIB表达水平降低,两者联合检测对肝硬化腹水患者并发SBP的诊断价值较高。
Objective This paper attempts to investigate the diagnostic value of peripheral blood neutrophil CD64 and serum fibrinogen(FIB)in cirrhotic patients with ascites complicated with spontaneous bacterial peritonitis(SBP).Methods A total of 60 cirrhotic patients with ascites complicated with SBP from June 2021 to November 2022 in Shijiazhuang Ping'an Hospital were into SBP group,another 60 cirrhotic patients without SBP were enrolled into non-SBP group.The basic data of sex,age,BMI,etiology of liver cirrhosis,laboratory indexes,symptoms and signs on admission were collected.Multivariate logistic regression model was used to analyze the risk factors of SBP in cirrhotic patients with ascites.The diagnostic value of neutrophil CD64,serum FIB and their combined detection in cirrhotic patients with ascites complicated with SBP was analyzed by ROC curve.Results The expression of neutrophil CD64 in SBP group is higher than that in non-SBP group,and the serum FIB in SBP group is lower than that in non-SBP group,with a statistically significant difference(P<0.05).The results of univariate analysis show that the proportion of patients with abdominal pain and fever,and the levels of ALT and white blood cell count(WBC)in SBP group are higher than those in non-SBP group,with a statistically significant difference(P<0.05).Multiple logistic regression analysis shows that fever and neutrophil CD64 are the risk factors of SBP in cirrhotic patients with ascites,while serum FIB is the protective factor(P<0.05).The ROC curve analysis shows that the area under the curve(AUC)of neutrophil CD64 combined with serum FIB in diagnosing SBP in cirrhotic patients with ascites is 0.965,which is significantly higher than that of neutrophil CD64 and serum FIB alone(ZCD64=2.214,P=0.027;ZFIB=3.941,P=0.000).Conclusions The expression of neutrophil CD64 in liver cirrhosis patients with ascites complicated with SBP is increased,while the expression of serum FIB is decreased.The combined detection of the two methods has a higher diagnostic value for SBP in cirrhotic patients with ascites.
作者
段树静
何志伟
郭楠楠
安江科
DUAN Shujing;GUO Nannan;AN Jiangke;HE Zhiwei(Department of Critical Medicine,Shijiazhuang Ping'an Hospital,Shijiazhuang 050000,China;Department of General Internal Medicine,Shijiazhuang Ping'an Hospital,Shijiazhuang 050000,China)
出处
《国际消化病杂志》
CAS
2023年第2期103-107,共5页
International Journal of Digestive Diseases
基金
河北省中医药管理局科研计划项目(2022210)。
