Objective To investigate the early diagnostic value of procalcitonin(PCT),serum amyloid A(SAA)and 16S ribosomal ribonucleic acid(16S rRNA)in patients with spontaneous bacterial peritonitis(SBP).Methods Our cohort of 121 liver cirrhotic ascites patients including 52 patients with SBP(research group)and 69 cases without SBP(control group). Serum PCT,SAA measurements and gene sequencing of 16S rRNA in ascites were carried out prior to the use of antibiotics.ResultsSerum PCT,SAA levels and the positive rate of 16S rRNA in SBP group were significantly higher than those in control group(P<0.05). For the diagnosis of SBP,the sensitivity and specificity of PCT were 90.38%and 82.61%,the sensitivity and specificity of SAA were 88.46% and 79.71%,the sensitivity and specificity of 16S rRNA were 82.69% and 98.55%. The area under the ROC curve of PCT was 0.888(95%CI0.821-0.955),the area under the ROC curve of SAA was 0.868(95%CI0.796-0.939), and the area under the ROC curve of PCT was 0.906(95%CI0.842-0.970).Conclusion The levels of Serum PCT and SAA in combination with 16S rRNA in ascites seem to provide a satisfactory early diagnostic biomarker in patients with SBP.%目的 探讨降钙素原(PCT)、淀粉样蛋白A(SAA)、16S rRNA在自发性腹膜炎(SBP)患者中的早期诊断价值.方法 肝硬化腹水患者121例,包括52例SBP患者(观察组)和69例非SBP患者(对照组),在使用抗生素前检测患者血清PCT、SAA水平和腹水16S rRNA基因序列.结果 SBP组血清PCT、SAA水平和16S rRNA阳性率明显高于对照组(P<0.05).PCT诊断SBP的敏感性90.38%,特异性82.61%;SAA诊断SBP的敏感性为88.46%,特异性为79.71%;16S rRNA诊断SBP的敏感性82.69%,特异性98.55%.PCT的ROC曲线下面积0.888(95%CI0.821~0.955),SAA的ROC曲线下面积0.868(95%CI0.796~0.939),16S rRNA的ROC曲线下面积0.906(95%CI0.842~0.970).结论 联合检测血清PCT、SAA和腹水16S rRNA可以为SBP患者提供一个满意的早期诊断指标.
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