Analysis Of The Value Of CRP,NLR And MPV In The Diagnosis Of Liver Cirrhosis Complicated With Spontaneous Peritonitis

Objective:To explore the value of CRP,NLR and MPV in the diagnosis of spontaneous bacterial peritonitis(SBP)in patients with liver cirrhosis,and to provide reference indexes for clinical prevention and treatment of SBP.Methods:The data of 201 patients with liver cirrhosis complicated with ascites hospitalized in the affiliated Hospital of Yanbian University from January 2015 to September 2020 were retrospectively analyzed.They were divided into two groups according to whether they were complicated with spontaneous peritonitis(SBP).The general data and laboratory test results of the two groups included peripheral blood leukocyte,platelet,lymphocyte count,neutrophil count,mean platelet volume(MPV),platelet distribution width(PDW),serum creatinine,serum bilirubin,serum albumin,AST,ALT,PT,APTT,CRP,etc,and calculated neutrophil count / lymphocyte count(NLR).And ascites culture,routine and biochemical results were compared and analyzed.Results:(1)Among the basic characteristics of liver cirrhosis complicated with ascites,there was no significant difference in age,sex,nationality and etiology between the two groups,while in the SBP group,there was 1 case of Child-Pugh grade A(1.4%),B grade 19 cases)(27.5%),C grade 48 cases(69.6%).In the non-SBP group,there were 0 cases of Child-Pugh grade A,81 cases of B grade(61.4%)and 51 cases of C grade(38.6%).There was significant difference in Child-Pugh score between the two groups(P< 0.001).(2)In the laboratory indicators of the two groups of patients,the levels of platelet,eosinophil,albumin,creatinine,PT,APTT,neutrophil count,white blood cell,MPV,NLR and CRP in SBP group were significantly higher than those in non-SBP group.The difference between the two groups is statistically significant(P<0.05).(3)The results of univariate difference analysis showed that liver function grade,ALB,APTT,PT,CRP,MPV,NLR,white blood cells,creatinine,eosinophils,platelets and neutrophils were significantly correlated with SBP.The factors related to AGI in univariate analysis were included in multivariate Logistic regression analysis.The results showed that CRP(OR(95%CI)=184.012(19.037～1778.642),P< 0.001),MPV(OR(95%CI)=7.015(2.044～24.078),P=0.002),NLR(OR(95%CI)=9.414(1.732～51.164),P=0.009)was confirmed to be an independent risk factor for the occurrence of SBP.(4)When the best cut-off value of CRP is 6.11,the sensitivity and specificity for the diagnosis of liver cirrhosis with SBP are 98.55% and 75.00%,and when the best cut-off value of MPV is 11.8,the sensitivity and specificity for the diagnosis of liver cirrhosis with SBP are 52.94% and 90.91%.When the best cut-off value of NLR is 6.178,the sensitivity and specificity for the diagnosis of liver cirrhosis with SBP are 46.38% and 93.18%.The sensitivity of the combination of the three in the diagnosis of liver cirrhosis complicated with SBP was 88.24%,and the specificity was 90.15%.According to the ROC curve analysis,the combined AUC of the three was 0.960,the AUC of CRP,MPV and NLR was 0.945,0.786 and 0.704,respectively,which were less than the AUC,of the combination of the three in the diagnosis of SBP,indicating that the value of the combination of the three in the diagnosis of SBP was higher than that of CRP,MPV and NLR.Conclusion:CRP,MPV and NLR are independent risk factors for the occurrence of SBP,and the combination of the three can be used as a simple,cheap and non-invasive method for the diagnosis of SBP.