Procalcitonin and C-Reactive Protein in the Diagnosis and Prediction of Spontaneous Bacterial Peritonitis Associated With Chronic Severe Hepatitis B
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) are inflammatory markers used to diagnose severe bacterial infections. We evaluated the diagnostic role of these markers and compared their accuracy for spontaneous bacterial peritonitis (SBP) associated with chronic severe hepatitis B (CSHB). Methods: PCT and CRP concentrations, WBC count, and other hematological parameters were measured in serum from 84 well-characterized patients with CSHB, of whom 42 had SBP. Receiver operating characteristics (ROC) curve analysis was performed to assess the diagnostic accuracy. Results: PCT and CRP concentrations were significantly higher in the CSHB patients with SBP (n=42) than CSHB patients without SBP (n=42). PCT and CRP concentrations were more accurate than WBC count for the diagnosis of CSHB-associated SBP. The optimal cutoff value of PCT was 0.48 ng/mL. The PCT concentration was significantly correlated with the CRP concentration and WBC count. Conclusions: Serum PCT and CRP seems to be better markers than WBC for the diagnosis of CSHB patients with SBP.
Abstract
Background: Procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) are inflammatory markers used to diagnose severe bacterial infections. We evaluated the diagnostic role of these markers and compared their accuracy for spontaneous bacterial peritonitis (SBP) associated with chronic severe hepatitis B (CSHB). Methods: PCT and CRP concentrations, WBC count, and other hematological parameters were measured in serum from 84 well-characterized patients with CSHB, of whom 42 had SBP. Receiver operating characteristics (ROC) curve analysis was performed to assess the diagnostic accuracy. Results: PCT and CRP concentrations were significantly higher in the CSHB patients with SBP (n=42) than CSHB patients without SBP (n=42). PCT and CRP concentrations were more accurate than WBC count for the diagnosis of CSHB-associated SBP. The optimal cutoff value of PCT was 0.48 ng/mL. The PCT concentration was significantly correlated with the CRP concentration and WBC count. Conclusions: Serum PCT and CRP seems to be better markers than WBC for the diagnosis of CSHB patients with SBP.
참고문헌 (37)
- Lavanchy D, "Worldwide epidemiology of HBV infection, disease burden, and vaccine prevention", J Clin Virol, 34, pp.S1~S3 (2005)
- Borzio M, "Bacterial infection in patients with advanced cirrhosis: a multicentre prospective study", Dig Liver Dis, 33, pp.41~48 (2001)
- Tandon P, "Bacterial infections, sepsis, and multiorgan failure in cirrhosis", Semin Liver Dis, 28, pp.26~42 (2008)
- Caly WR, "A prospective study of bacterial infections in patients with cirrhosis", J Hepatol, 18, pp.353~358 (1993)
- Thalheimer U, "Infection, coagulation, and variceal bleeding in cirrhosis", Gut, 54, pp.556~563 (2005)
- Massaro KS, "Procalcitonin (PCT) and C-reactive protein (CRP) as severe systemic infection markers in febrile neutropenic adults", BMC Infect Dis, 7, pp.137~ (2007)
- Yudkin JS, "C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?", Arterioscler Thromb Vasc Biol, 19, pp.972~978 (1999)
- Danesh J, "Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses", BMJ, 321, pp.199~204 (2000)
- Ridker PM, "C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women", N Engl J Med, 342, pp.836~843 (2000)
- Heney D, "Interleukin-6 and its relationship to C-reactive protein and fever in children with febrile neutropenia", J Infect Dis, 165, pp.886~890 (1992)
- Katz JA, "Value of C-reactive protein determination in the initial diagnostic evaluation of the febrile, neutropenic child with cancer", Pediatr Infect Dis J, 11, pp.708~712 (1992)
- Engel A, "An analysis of interleukin-8, interleukin-6 and C-reactive protein serum concentrations to predict fever, gram-negative bacteremia and complicated infection in neutropenic cancer patients", Infection, 26, pp.213~221 (1998)
- Lehrnbecher T, "Assessment of measuring circulating levels of interleukin-6, interleukin-8, C-reactive protein, soluble Fc gamma receptor type III, and mannose-binding protein in febrile children with cancer and neutropenia", Clin Infect Dis, 29, pp.414~419 (1999)
- Giamarellos-Bourboulis EJ, "Assessment of procalcitonin as a diagnostic marker of underlying infection in patients with febrile neutropenia", Clin Infect Dis, 32, pp.1718~1725 (2001)
- al-Nawas B, "Procalcitonin in patients with and without immunosuppression and sepsis", Infection, 24, pp.434~436 (1996)
- Assicot M, "High serum procalcitonin concentrations in patients with sepsis and infection", Lancet, 341, pp.515~518 (1993)
- Gendrel D, "Procalcitonin, C-reactive protein and interleukin 6 in bacterial and viral meningitis in children", Presse Med, 27, pp.1135~1139 (1998)
- Whang KT, "Serum calcitonin precursors in sepsis and systemic inflammation", J Clin Endocrinol Metab, 83, pp.3296~3301 (1998)
- Giamarellou H, "Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: experience from a multicentre study", Clin Microbiol Infect, 10, pp.628~633 (2004)
- Simon L, "Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis", Clin Infect Dis, 39, pp.206~217 (2004)
- Maruna P, "Physiology and genetics of procalcitonin", Physiol Res, 49, pp.S57~S61 (2000)
- Su DH, "Value of serum procalcitonin levels in predicting spontaneous bacterial peritonitis", Hepatogastroenterology, 60, pp.641~646 (2013)
- Ramsook C, "Comparison of blood culture contamination rates in a pediatric emergency room: newly inserted intravenous catheters versus venipuncture", Infect Control Hosp Epidemiol, 21, pp.649~651 (2000)
- Liu Q, "Characteristics of acute and sub-acute liver failure in China: nomination, classification and interval", J Gastroenterol Hepatol, 22, pp.2101~2106 (2007)
- Tandon P, "Bacterial infections, sepsis, and multiorgan failure in cirrhosis", Semin Liver Dis, 28, pp.26~42 (2008)
- Thalheimer U, "Infection, coagulation, and variceal bleeding in cirrhosis", Gut, 54, pp.56~63 (2005)
- Bota DP, "Serum levels of C-reactive protein and procalcitonin in critically ill patients with cirrhosis of the liver", J Lab Clin Med, 146, pp.347~351 (2005)
- Elefsiniotis IS, "Clinical significance of serum procalcitonin levels in patients with acute or chronic liver disease", Eur J Gastroenterol Hepatol, 18, pp.525~530 (2006)
- Viallon A, "Serum and ascitic procalcitonin levels in cirrhotic patients with spontaneous bacterial peritonitis: diagnostic value and relationship to pro-inflammatory cytokines", Intensive Care Med, 26, pp.1082~1088 (2000)
- Spahr L, "Procalcitonin is not an accurate marker of spontaneous bacterial peritonitis in patients with cirrhosis", Hepatogastroenterology, 48, pp.502~505 (2001)
- Connert S, "Procalcitonin is a valid marker of infection in decompensated cirrhosis", Z Gastroenterol, 41, pp.165~170 (2003)
- Papp M, "Acute phase proteins in the diagnosis and prediction of cirrhosis associated bacterial infections", Liver Int, 32, pp.603~611 (2012)
- Viallon A, "Serum and ascitic procalcitonin levels in cirrhotic patients with spontaneous bacterial peritonitis: diagnostic value and relationship to pro-inflammatory cytokines", Intensive Care Med, 26, pp.1082~1088 (2000)
- Runyon BA, "Ascitic fluid and serum C-reactive protein concentrations in patients with and without peritonitis", Am J Clin Pathol, 86, pp.773~775 (1986)
- Tsiakalos A, "Acute-phase proteins as indicators of bacterial infection in patients with cirrhosis", Liver Int, 29, pp.1538~1542 (2009)
- Lin ZY, "Clinical application of serum C-reactive protein measurement in the detection of bacterial infection in patients with liver cirrhosis", Kaohsiung J Med Sci, 18, pp.121~126 (2002)
- Li CH, "Procalcitonin as a biomarker for bacterial infections in patients with liver cirrhosis in the emergency department", Acad Emerg Med, 18, pp.121~126 (2011)
