The Value Of Clinical Diagnosis Of Serum PCT、CRP And IL-6 In Spontaneous Bacterial Peritonitis Complicated By Acute On Chronic Liver Failure

Objective: To investigate the the clinical diagnostic value of the serum procalcitonin(PCT), C-reactive protein(CRP) and Interleukin-6(IL-6) in acute on chronic liver failure(ACLF) patients complicated with spontaneous bacterial peritonitis(SBP),to effectively control liver failure progress and improve the prognosis of liver failure. Methods: 85 cases patients from our hospital in September, 2013-July, 2015 of liver failure were collected, which included liver failure complicated with spontaneous bacterial peritonitis(SBP)(49 cases) as observation group and liver failure without SBP peritonitis as control group(36 cases), to detect Procalcitonin, C-reactive protein and Interleukin-6 for all patients admitted to hospital within 24 hours, compared to the two groups of patients with the level of serum PCT, CRP and IL-6, and the results of indicators were statistically analyzed by using SPSS17.0. Results: There has no difference(P>0.05) between Liver failure group and non-SBP group in age, gender composition ratio and the composition ratio of the liver disease type. There were nosignificant difference in total bilirubin and prothrombin time activity between two groups(P > 0.05). Compared with the no-SBP group, the serum PCT, CRP and IL-6 were significantly higher(P<0.05); The area under the ROC curve of PCT was 0.940(95%C1 0.886~0.994), when the cut off value of 0.745ng/mL, the sensitivity of PCT is 87.76%, the specificity is 91.67%; The area under the ROC curve of CRP is 0.842(95%C1 0.758 ~ 0.925), when the cutoff value of 32.875ng/mL, the sensitivity of the CRP was 67.35%, the specificity is 91.67%; The area under the ROC curve of IL-6 is 0.702(95%C1 0.586~0.817), when the cutoff value of 30.875mg/dL, the sensitivity was 85.71%, the specificity is 50.00%; The sensitivity and specificity of combined measurement of PCT and CRP was 89.80%, 91.67%,respectively;the sensitivity and specificity of combined measurement of PCT and IL-6 was 93.88% and86.11%, respectively; the sensitivity and specificity of combined measurement of CRP and IL-6 was 67.35%, 91.37%, respectively. Coclunsion: PCT, CRP and IL-6 were prospective marker of bacterial infection in ACLF patients with spontaneous peritonitis.PCT has a strong sensitivity for diagnosis of infection, PCT and CRP have higer specificity than IL-6. Comprehensive analysis is conducive to accurately determine the incidence of infection.