PCT、SCD14和CD64在肝硬化并发自发性细菌性腹膜炎诊疗中的意义李春英1邹金海2梁育飞1（1.河北省沧州市屮心医院消化内一科河北沧州061001）（2.沧州市屮心医院核医学科河北沧州061001）【摘要】目的：检测肝硬化患者外周血及腹水降钙素原（PCT）、SCD14和CD64的水平，探讨外周血及腹水PCT、SCD14和CD64检测对白发性细菌性腹膜炎（SBP）的诊断价值。方法：将肝硬化患者分为肝硬化SBP组（30例组1）、肝硬化腹水非SBP组（30例）（组2）及健康对照组（30例）（组3）3组。应用电化学发光免疫法测定血清、腹水降钙素原；应用流式细胞术测定外周血及腹水CD64、SCD14。分别采集肝硬化SBP组患者在入院后24小时内、抗菌药物使用前及抗生素有效治疗7d的空腹上肢静脉血及无菌腹水,测定患者体内PCT、sCD14和CD64水平，同时行血常规、肝肾功能、凝血功能检查。肝硬化腹水非SBP组及健康对照组一次性采血及抽腹水测定以上指标。结果:SBP组治疗前外周血PCT、SCD14和CD64水平较腹水非SBP组和对照组明显升高，差异有统计学意义（P<0.01）,而腹水非SBP组和对照组间比较差异无统计学意义（P〉0.05）;SBP组治疗前腹水PCT、SCD14和CD64水平较腹水非SBP组明显升高，差异有统计学意义（P<0.01）;治疗后肝硬化SBP组血及腹水PCT、SCD14和CD64水平明显卜'降，与治疗前比较差异有统计学意义（P<0.05>;另SBP组治疗前后腹水屮PCT、SCD14和CD64水平均明显高于外周血屮的水平,差异均有统计学意义（P<0.05）。结论：血及腹水屮PCT、SCD14和CD64水平检测对于肝硬化SBP的早期诊断、疗效判定有一定的临床意义；且腹水检测敏感度优于外周血检测。【关键词】肝硬化；降钙素原；SCD14；CD64；自发性细菌性腹膜炎【屮图分类号】R657.3+1【文献标识码】B【文章编号】1003-5028(2015)8-0872-02ClinicalsignificanceofPCT、sCD14andCD64inpatientswithcirrhosisandspontaneousbacterialperitonitis[Abstract]Objective：TodetecttheconcentrationofPCT,sCD14andCD64inbloodandascitesandinvestigatethediagnosisvalueofPCT,sCD14andCD64inbloodandascites.Methods：Therewerethreegroups.Thesixtypatientswithlivercirrhosisweredividedintotwogroups.Livercirrhosiswithspontaneousbacterialperitonitis(SBP)(30patients)wereingroup1andlivercirrhosiswithoutSBP(30patients)wereingroup2.Thirtyhealthysubjectswereincontrolgroup(group3).ThePCTinbloodandasciteswasdeteminedbyelectrochemiluminescenceimmunoassay(ECLI)andThesCD14andCD64inbloodandascitesweredeterminedbyflowcytometry.Thefastingvenousbloodintheupperlimbandasciteswereobtainedfrompatientsingroup1atthetimeofwithin24hoursafteradmission,beforeuseofantibioticsandsevendaysafterantibioticeffectivetreatment.ThePCT,sCD14andCD64weredetectedandatthesametimethebloodcount,liver,kidneyandbloodcoagulatefunctionsweretested.AIIthesametestswereappliedingroup2andgroup3.Results：TheconcentrationofPCT,sCD14andCD64inbloodwashigherthanthatingroup2andgroup3beforetreatmentwhichhadstatisticaldifferences(P<0.01).Therehadnostatisticaldifferencesbetweengroup2andgroup3(P>0.05).TheconcentrationofPCT,sCD14andCD64inasciteswashigherthanthatingroup2.TheconcentrationofPCTzsCD14andCD64inbloodandasciteshaddecreaseddramaticlypost-treatmentingroupl.Therehadstatisticaldifferencescomparedwithpretreatment(P<0.05).TheconcentrationofPCT,sCD14andCD64inasciteswashigherthanthatinbloodandtherehadstatisticaldifferences(P<0.05).Conclusions：ThedetectionoftheconcentrationofPCT,sCD14andCD64inbloodandasciteshadcertainclinicalsignificanceindiagnosisandjudgementofcurativeeffect.Thedetectionsensitivityofasciteswassuperiortothatofblood.【Keywords】Livercirrhosis;procalcitonin;sCD14;CD64;spontaneousbacterialperitonitis肝硬化腹水患者并发自发性细菌性腹膜炎（spontaneousbacterialperitonitis,SBP）,...