發(fā)布時(shí)間：2018-08-30 12:58

【摘要】：目的探討肝硬化患者腹水感染與血清降鈣素原(PCT)的相關(guān)性,為肝硬化腹水感染的診斷提供參考。方法選擇2013年4月-2015年4月于醫(yī)院接受治療的50例病毒性肝炎肝硬化腹水細(xì)菌性腹膜炎患者作為試驗(yàn)組,另選取50例病毒性肝炎腹水未感染患者作為對(duì)照組,采集試驗(yàn)組患者腹水樣本,予以細(xì)菌培養(yǎng)、鑒定及藥敏試驗(yàn),同時(shí)檢測(cè)兩組患者血清PCT、多形核白細(xì)胞(PMN)、白細(xì)胞(WBC)數(shù),觀察患者腹水中細(xì)菌培養(yǎng)陽性率及血清PCT檢測(cè)結(jié)果分布、各時(shí)段PTC濃度變化。結(jié)果試驗(yàn)組患者腹水樣本共分離出病原菌133株,革蘭陽性菌共52株占39.10%,革蘭陰性菌65株占48.87%,真菌15株占11.28%,抗酸桿菌1株占0.75%;試驗(yàn)組患者血清中PTC、PMN、WBC檢測(cè)結(jié)果均顯著高于對(duì)照組,比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);血清PCT以0.5ng/ml為陽性界值,則血清PCT對(duì)腹膜炎診斷敏感度為96.00%,對(duì)照組全為陰性。試驗(yàn)組患者隨著治療的介入,腹水感染得到改善,其血清中PCT水平也隨之降低,而對(duì)照組患者血清中PCT水平則變化不明顯。結(jié)論肝硬化患者中血清PCT和腹水感染成正相關(guān),且具有較高的敏感性,對(duì)肝硬化腹水感染患者的診斷及治療有著較高的臨床參考價(jià)值。在對(duì)肝硬化腹水感染患者治療時(shí)要合理對(duì)抗菌藥物進(jìn)行選擇,并及時(shí)進(jìn)行細(xì)菌培養(yǎng)和藥敏試驗(yàn)。
[Abstract]:Objective To investigate the correlation between ascites infection and serum procalcitonin (PCT) in patients with cirrhosis and to provide reference for the diagnosis of ascites infection in cirrhosis.Methods 50 patients with viral hepatitis and ascites bacterial peritonitis who were treated in hospital from April 2013 to April 2015 were selected as experimental group and 50 patients with viral hepatitis and ascites were not infected. Patients with infection were taken as control group. Ascites samples of test group were collected for bacterial culture, identification and drug susceptibility test. Serum PCT, polymorphonuclear leukocyte (PMN) and white blood cell (WBC) were detected in both groups. The positive rate of bacterial culture in ascites, the distribution of serum PCT test results, and the changes of PTC concentration in each period were observed. A total of 133 pathogenic bacteria were isolated from the water samples, 52 of them were Gram-positive bacteria (39.10%), 65 of them were Gram-negative bacteria (48.87%), 15 of them were fungi (11.28%) and 1 of them was acid-fast bacilli (0.75%). The results of PTC, PMN and WBC in the serum of the experimental group were significantly higher than those of the control group (P 0.05), and the PCT in the serum was 0.5 ng/ml as the positive limit, while the blood was 0.5 ng/ml as the positive limit. The sensitivity of serum PCT to the diagnosis of peritonitis was 96.00%. The control group was all negative. With the intervention of treatment, ascites infection was improved in the experimental group, and the serum PCT level was also decreased, while the serum PCT level in the control group was not significantly changed. Sensitivity has a high clinical reference value for the diagnosis and treatment of cirrhosis patients with ascites infection. In the treatment of cirrhosis patients with ascites infection, it is necessary to select reasonable antibiotics, and timely bacterial culture and drug sensitivity test.
【作者單位】： 重慶醫(yī)科大學(xué)附屬永川醫(yī)院消化內(nèi)科;重慶醫(yī)科大學(xué)附屬永川醫(yī)院感染科;
【基金】：重慶市衛(wèi)生局基金資助項(xiàng)目(2012-2-177)
【分類號(hào)】：R575.2

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