| 陈琦,赵宁,王本勇,王鸣.降钙素原在腹膜透析相关腹膜炎中的诊断价值[J].浙江中西医结合杂志,2019,29(11): |
| 降钙素原在腹膜透析相关腹膜炎中的诊断价值 |
| The diagnostic value of procalcitonin in peritoneal dialysis-associated peritonitis |
| 投稿时间：2019-03-11 修订日期：2019-06-08 |
| DOI： |
| 中文关键词: 腹膜透析 降钙素原 腹透相关腹膜炎 超敏C-反应蛋白 |
| 英文关键词:Peritoneal dialysis Procalcitonin Peritoneal dialysis-related peritonitis Hypersensitive C-reactive protein |
| 基金项目:浙江省科技发展计划(No.2014C33237)；杭州市科技发展计划(No.20140733Q10)； |
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| 中文摘要: |
| 目的：研究降钙素原（Procalcitonin,PCT）在腹膜透析相关腹膜炎患者血清及腹透液中的浓度，探讨降钙素原在腹透相关腹膜炎早期诊断中的临床意义。方法：收集单中心维持性腹膜透析患者100例，根据是否并发腹膜透析相关腹膜炎，分成腹膜炎组（50例）和对照组（50例），采集两组腹透液标本行 PCT、超敏C反应蛋白（Hypersensitive c-reactive protein,hs-CRP）检测、白细胞 (White blood cell,WBC) 计数；采集两组组血清标本行 PCT、hs-CRP 检测；比较各组PCT差异，将PCT与其它炎症指标进行相关性分析，并行ROC曲线分析血清及腹透液PCT腹透相关腹膜炎早期诊断的敏感度和特异度。结果：1、腹膜炎组血清PCT值为2.03±2.14ng/ml，显著高于对照组0.27±0.16ng/ml(P<0.01)，腹膜炎组腹透液 PCT 值为1.07±0.60ng/ml，显著高于对照组 0.06±0.02ng/ml(P<0.01)。2、血清PCT与腹透液PCT、血清hs-CRP均呈正相关，相关系数分别为0.99,0.90(P<0.001)，腹透液PCT与腹透液hs-CRP及WBC计数均呈正相关，相关系数分别为0.93,0.95（P<0.001）3、以血清 PCT 0.51ng/ml为截断值诊断腹透相关腹膜炎，敏感度为69.2%，特异度为 61.5%；以腹透液PCT 0.10ng/ml为截断值诊断腹透相关腹膜炎，敏感度为 96.2%，特异度为 89.2%。结论：显著升高的血清及腹透液PCT水平可作为腹透相关腹膜炎早期诊断的有用指标。 |
| 英文摘要: |
| Objective: The aim of this study was to detect the procalcitonin (PCT) levels in in patients with peritoneal dialysis（PD）-related peritonitis. Also, we investigated diagnostic value of procalcitonin in peritoneal dialysis(PD)-related peritonitis.Methods: A single centered，retrospective study was carried out to examine 100 PD patients，in which the patients with peritonitis served as peritonitis group，and without served as control group．The serum samples of each group were collected for PCT and hs-CRP, the dialysate samples of each group were collected for PCT, hs-CRP and white blood count. The correlation of PCT with other inflammatory markers in study group was analyzed．The value of PCT for early diagnosis of peritonitis associated with peritonitis in was assessed by ROC curve analysis．Results: 1. The serum PCT of peritonitis group (2.03±2.14 ng/ml) was significantly higher compared with control group (0.27±0.16 ng/mL). PCT levels in dialysate of peritonitis group (1.07±0.60ng/ml) was also significantly higher compared with control group (0.06±0.02 ng/mL).2.In peritonitis group,serum PCT was positively correlated with dialysate PCT and serum hs-CRP(r=0.99 and 0.90,both P<0.001)，dialysate PCT was positively correlated with dialysate hs-CRP and white blood count (r=0.93 and 0.95,both P<0.001)．3. ROC curve analysis showed that at a serum PCT cutoff value of 0.51ng/ml,the sensitivity and specificity for identifying the peritoneal dialysis（PD）-related peritonitis were 0.692 and 0.615 respectively．While When the cutoff value of PCT in peritoneal dialysis was 0.10ng/ml, the sensitivity and specificity were 0.962 and 0.892 respectively.Conclusions: Significantly increased serum and dialysate PCT levels can be used as a useful indicator for the early diagnosis of peritoneal dialysis-related peritonitis. |
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