慢性乙肝合并细菌感染患者血清PCT、CRP及IL-6水平变化的意义
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摘要
目的:分析慢性乙肝合并细菌感染患者血清降钙素原(PCT)、C反应蛋白(CRP)及白介素-6(IL-6)水平变化与细菌感染的关系。方法:收集2016年2月至2018年4月广西钦州市第二人民医院收治的88例慢性乙肝患者为研究对象,其中35例患者发生细菌感染,作为感染组;未发生感染的53例作为未感染组。获取所有患者血清标本,检测PCT、CRP与IL-6水平,评价其诊断细菌感染的特异性、敏感性。结果:与未感染组相比,感染组患者血清PCT、CRP、IL-6水平显著高,差异有统计学意义(P<0.05)。血清PCT、CRP、IL-6的受试者工作特征(ROC)曲线下面积依次为0.87、0.82、0.76,其诊断合并细菌感染的特异性、敏感性均>70%,其中PCT的特异性、敏感性均>85%,与CRP、IL-6相比诊断效能更高。Pearson相关分析显示,慢性乙肝患者血清PCT与CRP、IL-6呈正相关关系,CRP与IL-6呈正相关关系(均P<0.05)。结论:慢性乙肝合并细菌感染患者血清PCT、CRP与IL-6水平明显升高,PCT对细菌感染的诊断效能较高,PCT、CRP与IL-6均可作为预测细菌感染的血清标志物。
Objective:To analyze the relationship between the changes of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in patients with chronic hepatitis B and bacterial infection.Methods:A total of 88 patients with chronic hepatitis B admitted to our hospital from February 2016 to April 2018 were selected,including 35 cases with bacterial infection(infection group)and 53 cases without infection(non-infection group).Serum levels of PCT,CRP and IL-6 were measured,and their specificity and sensitivity in the diagnosis of bacterial infection were evaluated.Results:Compared with non-infection group,the levels of serum PCT,CRP and IL-6 were significantly higher in infection group(P<0.05).The area under the receiver operating characteristic(ROC)curve of PCT,CRP and IL-6 was 0.87,0.82 and0.76,respectively.The specificity and sensitivity of PCT,CRP and IL-6 in the diagnosis of bacterial infection were over 70%,and the specificity and sensitivity of PCT were over 85%,and the diagnostic efficacy of PCT was higher than that of CRP and IL-6.Pearson correlation analysis showed that serum PCT was positively correlated with CRP and IL-6 in patients with chronic hepatitis B,and CRP was positively correlated with IL-6(P<0.05).Conclusion:The serum levels of PCT,CRP and IL-6 were significantly increased in patients with chronic hepatitis B complicated with bacterial infection,and PCT had higher diagnostic efficacy for bacterial infection.PCT,CRP and IL-6 could be used as the predictive indicators for bacterial infection.
Objective:To analyze the relationship between the changes of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in patients with chronic hepatitis B and bacterial infection.Methods:A total of 88 patients with chronic hepatitis B admitted to our hospital from February 2016 to April 2018 were selected,including 35 cases with bacterial infection(infection group)and 53 cases without infection(non-infection group).Serum levels of PCT,CRP and IL-6 were measured,and their specificity and sensitivity in the diagnosis of bacterial infection were evaluated.Results:Compared with non-infection group,the levels of serum PCT,CRP and IL-6 were significantly higher in infection group(P<0.05).The area under the receiver operating characteristic(ROC)curve of PCT,CRP and IL-6 was 0.87,0.82 and0.76,respectively.The specificity and sensitivity of PCT,CRP and IL-6 in the diagnosis of bacterial infection were over 70%,and the specificity and sensitivity of PCT were over 85%,and the diagnostic efficacy of PCT was higher than that of CRP and IL-6.Pearson correlation analysis showed that serum PCT was positively correlated with CRP and IL-6 in patients with chronic hepatitis B,and CRP was positively correlated with IL-6(P<0.05).Conclusion:The serum levels of PCT,CRP and IL-6 were significantly increased in patients with chronic hepatitis B complicated with bacterial infection,and PCT had higher diagnostic efficacy for bacterial infection.PCT,CRP and IL-6 could be used as the predictive indicators for bacterial infection.
引文
[1]庄权权,林志航,蒋燕成,等.慢性乙型肝炎病毒感染患者血清免疫调节因子检测的临床意义[J].中华医院感染学杂志,2016,26(1):1-3.
[2]李连海,齐敏.不同核苷类似物治疗乙型肝炎肝硬化失代偿期的疗效及对相关炎性细胞因子水平的影响[J].广西医科大学学报,2016,33(5):849-851.
[3]GIANNELLI V,GREGORIO V D,IEBBA V,et al.Microbiota and the gut-liver axis:Bacterial translocation,inflammation and infection in cirrhosis[J].World Journal of Gastroenterology Wjg,2014,20(45):16795-16810.
[4]孟庆华,侯维.2015年版《慢性乙型肝炎防治指南》-慢性乙型肝炎抗病毒治疗指南解读[J].中国全科医学,2016,19(14):1613-1615.
[5]郑金莲,胡操寒,潘华将,等.乙型肝炎肝硬化患者细菌感染诱发肝性脑病的临床治疗效果分析[J].中华医院感染学杂志,2016,26(4):742-743.
[6]刁云辉,薛萌,沙金平,等.细菌感染诱发肝性脑病乙型肝炎肝硬化临床特点研究[J].中华医院感染学杂志,2016,26(6):1276-1278.
[7]WU H,CHEN L,SUN Y,et al.The role of serum procalcitonin and C-reactive protein levels in predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis:[J].Pakistan Journal of Medical Sciences,2016,32(6):1484-1488.
[8]范永熙,单海滨,李兆然.急性胰腺炎患者血清PCT、IL-6和hs-CRP水平变化的临床意义[J].中国现代医学杂志,2014,24(10):46-49.
[9]韩杰,薛玉龙,汪传一,等.腹部外伤患者术后血清IL-6和PCT及CRP水平与感染的相关性研究[J].中华医院感染学杂志,2017,27(20):4708-4711.
[10]丁爽,蒋清清,马萍.血清PCT、CRP和IL-6联合检测对细菌性血流感染早期诊断价值[J].实用医学杂志,2016,32(18):3075-3077.
[11]苑文雯,王晗,何叶莉,等.降钙素原与C反应蛋白及白细胞介素-6联合检测在慢性乙型肝炎中的临床意义[J].检验医学与临床,2015,12(2):184-185.
[12]张宗祥,金,方迪龙,等.外科腹腔感染患者PCT与TNF-α及CRP和IL-6水平与感染程度的研究[J].中华医院感染学杂志,2017,27(20):4712-4715.
[13]李英,计超,潘在兴.脓毒症患者血清PCT、hsCRP及IL-6表达水平及其临床意义[J].海南医学,2018,29(2):212-214.
[14]缪希莉,梅四清,高贵民.血清降钙素原联合炎症指标对慢性重型乙型肝炎合并自发性细菌性腹膜炎的诊断价值[J].广东医学,2016,37(17):2625-2628.
[2]李连海,齐敏.不同核苷类似物治疗乙型肝炎肝硬化失代偿期的疗效及对相关炎性细胞因子水平的影响[J].广西医科大学学报,2016,33(5):849-851.
[3]GIANNELLI V,GREGORIO V D,IEBBA V,et al.Microbiota and the gut-liver axis:Bacterial translocation,inflammation and infection in cirrhosis[J].World Journal of Gastroenterology Wjg,2014,20(45):16795-16810.
[4]孟庆华,侯维.2015年版《慢性乙型肝炎防治指南》-慢性乙型肝炎抗病毒治疗指南解读[J].中国全科医学,2016,19(14):1613-1615.
[5]郑金莲,胡操寒,潘华将,等.乙型肝炎肝硬化患者细菌感染诱发肝性脑病的临床治疗效果分析[J].中华医院感染学杂志,2016,26(4):742-743.
[6]刁云辉,薛萌,沙金平,等.细菌感染诱发肝性脑病乙型肝炎肝硬化临床特点研究[J].中华医院感染学杂志,2016,26(6):1276-1278.
[7]WU H,CHEN L,SUN Y,et al.The role of serum procalcitonin and C-reactive protein levels in predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis:[J].Pakistan Journal of Medical Sciences,2016,32(6):1484-1488.
[8]范永熙,单海滨,李兆然.急性胰腺炎患者血清PCT、IL-6和hs-CRP水平变化的临床意义[J].中国现代医学杂志,2014,24(10):46-49.
[9]韩杰,薛玉龙,汪传一,等.腹部外伤患者术后血清IL-6和PCT及CRP水平与感染的相关性研究[J].中华医院感染学杂志,2017,27(20):4708-4711.
[10]丁爽,蒋清清,马萍.血清PCT、CRP和IL-6联合检测对细菌性血流感染早期诊断价值[J].实用医学杂志,2016,32(18):3075-3077.
[11]苑文雯,王晗,何叶莉,等.降钙素原与C反应蛋白及白细胞介素-6联合检测在慢性乙型肝炎中的临床意义[J].检验医学与临床,2015,12(2):184-185.
[12]张宗祥,金,方迪龙,等.外科腹腔感染患者PCT与TNF-α及CRP和IL-6水平与感染程度的研究[J].中华医院感染学杂志,2017,27(20):4712-4715.
[13]李英,计超,潘在兴.脓毒症患者血清PCT、hsCRP及IL-6表达水平及其临床意义[J].海南医学,2018,29(2):212-214.
[14]缪希莉,梅四清,高贵民.血清降钙素原联合炎症指标对慢性重型乙型肝炎合并自发性细菌性腹膜炎的诊断价值[J].广东医学,2016,37(17):2625-2628.