Abstract:

【Abstract】Objective To investigate the clinical significance of TNFα and hsCRP levels in ascites for diagnosis of cirrhotic patients with spontaneous bacterial peritonitis. Methods Eighty cirrhosis patients with ascites but no clinical symptoms were selected in this study..All patients received the routine test of ascites and ascitic bacterial culture,.and they were divided into two groups, positive bacterial group and negative bacterial group(n=40, each). TNFα level in serum and ascites were measured by radio-immunity method..HsCRP was measured by ultra ion immune transmisson turbidimetry. Results The levels of TNFα and hsCRP in serum and ascites in positive ascitic fluid culture group was significantly high than those in negative ascitic fluid culture group, especially in ascites (P<0.05). There is a positive correlation between TNFα level and hs-CRP level in ascites or serum. After antibiotics treatment for one week, both levels of serum and ascites TNFα and hsCRP were significantly decreased..Conclusion Detection of TNFαand hsCRP in ascites is helpful to the early diagnosis of cirrhotic patients with spontaneous bacterial peritonitis.

Key words: Cirrhosis, Spontaneous bacterial peritonitis, TNFα, hsCRP

摘要：

【摘要】 目的 探讨肝炎肝硬化患者腹水中肿瘤坏死因子α( TNFα)和超敏C-反应蛋白(hsCRP)水平对自发性细菌性腹膜炎(SBP)诊断的临床意义。方法 选择在我院住院治疗的有腹水但无腹痛及发热等腹膜炎症状的肝硬化失代偿期患者80例,行腹水常规检查,细菌培养,放免法测定血清及腹水TNFα,超离子免疫透射比浊法测定法检测hsCRP水平。结果 在细菌培养阳性的合并自发性腹膜炎组(39例) TNFα和hsCRP水平远高于腹水培养阴性的无自发性腹膜炎组(41例),以腹水中升高更为明显(P<0.05),无论腹水还是血清两种指标峰值均呈正相关。自发性腹膜炎组经抗炎治疗1周后,患者血清及TNFα、hsCRP水平明显下调。结论 检测血清及腹水TNFα、hsCRP水平对肝硬化合并自发性细菌性腹膜炎早诊断判断有一定价值。

关键词: 肝硬化, 自发性细菌性腹膜炎, 肿瘤坏死因子α, 超敏C-反应蛋白