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目的 :探讨各种急性时相蛋白 (APP)对肝硬化继发感染早期诊断的临床价值及各项 APP对感染预测的参考值。方法 :采用全自动速率散射比浊法对 5 1例肝硬化患者进行 4种 APP〔C反应蛋白 (CRP)、α1 酸性糖蛋白 (AAG)、铜蓝蛋白 (CER)和触珠蛋白 (HPT)〕的动态检测 ,2 5例肝硬化继发感染者中 14例于感染控制后再行监测 ,并与非肝硬化感染组、非肝硬化无感染组进行对比分析。结果 :肝硬化继发感染患者入院第 2日CRP、AAG、HPT显著高于无继发感染组 ,以正常人群的 APP水平上限为标准 (即 8mg/ L ) ,则 CRP对感染诊断的敏感度及特异度分别为 88.0 0 %和 76 .92 % ;如 CRP以肝硬化无感染组的 95 %正常值为参比值上限 (即16 mg/ L) ,则特异度为 92 .31% ;其它 3项 APP的敏感度较低 ,但特异度高 ;如 CRP和 AAG两项指标结合判断 (即同时 CRP≥ 8mg/ L ,AAG≥ 12 5 0 mg/ L为参比值 ) ,本资料中感染特异度判断达 10 0 %。 CRP以 8mg/ L为参考值上限 ,外周血白细胞计数高于 10× 10 9/ L 为异常 ,则 CRP与外周血白细胞计数相比 ,入院第 2日肝硬化并感染患者的异常率分别为 88.0 0 %和 31.82 %。对 14例感染控制前后患者的 APP动态监测发现 ,CRP呈显著负相关 ,而其它 3项指标差异不显著。结论 :CRP,AAG和 HPT对诊断肝?
Objective: To investigate the clinical value of various acute phase proteins (APP) in the early diagnosis of secondary cirrhosis infection and the reference value of each APP in predicting the infection. Methods: Four types of APP (CRP, α1 acid glycoprotein (AAG), ceruloplasmin (CER) and haptoglobin (HPT)) were obtained from 51 cirrhotic patients by automatic rate nephelometry ], 14 of 25 cases of secondary infection of cirrhosis were monitored after infection control and compared with non-cirrhosis group and non-cirrhotic non-infected group. Results: The CRP, AAG and HPT were significantly higher in patients with secondary liver cirrhosis than those without secondary infection at the second day of hospital admission. The upper limit of APP level in normal population was the standard (8mg / L), and the sensitivity of CRP to infection diagnosis And specificity were 88.0% and 76.92% respectively. The specificity was 92.31% if the CRP was 95% of the normal liver cirrhosis without infection (16 mg / L), and the other 3 The sensitivity of the APP was lower but the specificity was high. For example, CRP and AAG combined with CRP and AAG (ie CRP≥8mg / L and AAG≥125.0mg / L as the reference value), the specificity of infection in this data Judgment of up to 10%. CRP 8mg / L as the upper limit of reference, peripheral blood leukocyte count higher than 10 × 10 9 / L is abnormal, CRP and peripheral blood leukocyte count compared to admission on the 2nd day of cirrhosis and infection in patients with abnormal rates were 88.0 0% and 31.82%. The dynamic changes of APP in 14 patients before and after infection control showed that there was a significant negative correlation between CRP and other three indexes. Conclusion: CRP, AAG and HPT for the diagnosis of liver?