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目的探讨乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中糖链抗原125(sugar chain antigen 125,CA125)及降钙素原(procalcitonin,PCT)的变化情况。方法选择2013年1月—2016年6月杭州市西溪医院乙肝肝硬化腹水合并自发性细菌性腹膜炎患者60例作为观察组、乙肝肝硬化腹水未合并自发性细菌性腹膜炎患者60例作为对照组。测定2组患者血清和腹水中CA125、PCT水平。结果观察组血清CA125和PCT水平[(425.76±157.43)U/L、(1.326±0.434)ng/ml]均高于对照组[(314.27±132.95)U/L、(0.587±0.276)ng/ml],P<0.05。观察组腹水CA125和PCT水平[(567.34±213.75)U/L、(0.983±0.316)ng/ml]均高于对照组[(378.52±167.53)U/L、(0.214±0.105)ng/ml],P<0.05。抗生素治疗有效患者47例中,治疗后血清和腹水CA125、PCT水平[(411.53±152.13)U/L、(1.279±0.424)ng/ml;(558.76±202.14)U/L、(0.946±0.307)ng/ml)]均低于治疗前[(331.86±143.25)U/L、(0.635±0.265)ng/ml;(385.42±197.47)U/L、(0.546±0.324)ng/ml],P<0.05。血清CA125和腹水CA125呈正相关(r=0.882,P<0.001),血清PCT和腹水PCT呈正相关(r=0.856,P<0.001)。血清CA125水平和血清PCT水平无显著相关性(P>0.05)。结论乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中CA125、PCT水平升高,经抗生素治疗有效患者血清和腹水中CA125、PCT水平下降。
Objective To investigate the changes of serum and ascites carbohydrate antigen 125 (CA125) and procalcitonin (PCT) in patients with hepatitis B cirrhosis complicated with spontaneous bacterial peritonitis. Methods From January 2013 to June 2016, 60 patients with hepatitis B cirrhosis and spontaneous bacterial peritonitis in Xixi Hospital of Hangzhou City were selected as the observation group. 60 patients with hepatitis B cirrhosis with spontaneous bacterial peritonitis were used as the control group. Serum and ascites CA125, PCT levels were measured in two groups. Results The levels of serum CA125 and PCT in the observation group [(425.76 ± 157.43) U / L, (1.326 ± 0.434) ng / ml] were significantly higher than those in the control group (314.27 ± 132.95 U / L and 0.587 ± 0.276 ng / ], P <0.05. The levels of CA125 and PCT in the ascites of the observation group were significantly higher than those in the control group [(567.34 ± 213.75) U / L, (0.983 ± 0.316) ng / ml] [(378.52 ± 167.53) U / L] , P <0.05. Among the 47 patients with effective antibiotic therapy, the levels of serum CA125 and PCT in the serum and ascites after treatment were (411.53 ± 152.13) U / L, (1.279 ± 0.424) ng / ml, (558.76 ± 202.14) U / L and (0.946 ± 0.307) ng / ml) were lower than those before treatment [(331.86 ± 143.25) U / L, (0.635 ± 0.265) ng / ml, (385.42 ± 197.47) U / L and (0.546 ± 0.324) ng / 0.05. There was a positive correlation between serum CA125 and ascites CA125 (r = 0.882, P <0.001). There was a positive correlation between serum PCT and ascites PCT (r = 0.856, P <0.001). There was no significant correlation between serum CA125 level and serum PCT level (P> 0.05). Conclusions The level of CA125 and PCT in serum and ascites of patients with hepatitis B cirrhosis complicated with spontaneous bacterial peritonitis increased, and the levels of CA125 and PCT in serum and ascites decreased with the effective antibiotic treatment.