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目的 :探讨检测血清C反应蛋白(CRP)、内毒素(LPS)及血清/腹水蛋白梯度值鉴别诊断自发性腹膜炎(SBP)患者的临床价值。方法 :选取本院消化内科2013年2月~2014年1月收治60例肝硬化腹水合并SBP患者作为(SBP)组,60例年龄、性别相匹配的肝硬化单纯腹水患者作为对照组,检测两组患者血清CRP、LPS及血清/腹水蛋白梯度值等指标并进行分析。结果 :SBP组患者与对照组患者的ALT、AST、TBIL、ALB、PA、TC、PT测定值差异均无统计学意义;SBP组患者的CRP、LPS水平显著的高于对照组,SBP组患者的SAAG水平显著的低于对照组患者;CRP鉴别诊断肝硬化腹水合并SBP的临界值为16.00 mg/L,LPS的临界值为8.55 pg/ml,SAAG的临界值为20.86g/L;CRP+LPS+SAAG三者联合应用诊断肝硬化腹水合并SBP患者的ROC曲线下面积AUC值为0.918,诊断灵敏度为87.29%、特异度为93.06%。结论 :CRP、LPS及SAAG三者联合应用对于鉴别诊断肝硬化腹水合并SBP患者具有较高的临床价值。
Objective: To investigate the clinical value of serum C-reactive protein (CRP), endotoxin (LPS) and serum / ascites protein gradient in the differential diagnosis of patients with spontaneous peritonitis (SBP). Methods: Sixty patients with cirrhosis with ascites combined with SBP (SBP) and 60 age-and-gender-matched ascites patients with cirrhosis as control group were selected from February 2013 to January 2014 in our hospital. Group of patients with serum CRP, LPS and serum / ascites protein gradient and other indicators and analysis. Results: There was no significant difference in ALT, AST, TBIL, ALB, PA, TC and PT between SBP group and control group. CRP and LPS in SBP group were significantly higher than those in control group and SBP group Of SAAG was significantly lower than that of the control group. The cutoff value of CRP for the diagnosis of cirrhosis with ascites combined with SBP was 16.00 mg / L, the cutoff value of LPS was 8.55 pg / ml, the cutoff value of SAAG was 20.86 g / L, The area under the ROC curve of LPS + SAAG in diagnosing cirrhotic patients with ascites combined with SBP was 0.918, the diagnostic sensitivity was 87.29% and the specificity was 93.06%. Conclusion: The combined use of CRP, LPS and SAAG has high clinical value in the differential diagnosis of patients with ascites due to cirrhosis and SBP.