目的 通过观察肝硬化并发自发性腹膜炎患者的血清与腹水中PCT、IL-17水平,旨在分析血清与腹水中PCT、IL-17水平诊断肝硬化患者并发腹膜炎的价值。方法 回顾性分析,采集我院2017年9月至2019年9月期间收治的110例肝硬化患者病历资料,根据患者是否合并自发性腹膜炎进行有效分组,其中未合并自发性腹膜炎的40例患者纳入对照组,合并自发性腹膜炎的70例患者纳入观察组,分别对比两组血清与腹水中PCT、IL-17水平,并采用双变量Pearson直线相关检验分析PCT与IL-17之间的相关性,分析血清与腹水中PCT、IL-17分别与肝硬化患者并发自发性腹膜炎的关系及其诊断肝硬化并发自发性腹膜炎的价值。结果 观察组血清、腹水中PCT、IL-17水平均较对照组高,差异均有统计学意义(P＜0.05)；经双变量Pearson直线相关性检验结果显示,血清中PCT与IL-17水平呈正相关(r=0.707,P＜0.001),腹水中PCT与IL-17水平呈正相关(r=0.675,P＜0.001)；将肝硬化患者是否并发自发性腹膜炎作为因变量,将血清与腹水中PVT、IL-17分别作为自变量,行二元Logistic回归分析结果显示,血清与腹水中PCT、IL-17水平过表达均可能是造成肝硬化患者并发自发性腹膜炎的主要因素(OR＞1,P＜0.05)；将血清与腹水中PCT、IL-17参数水平分别作为检验变量,将肝硬化患者是否并发自发性腹膜炎作为状态变量,绘制ROC曲线,结果显示血清与腹水中PCT、IL-17参数水平分别预测肝硬化患者并发自发性腹膜炎的AUC分别为：0.973、0.950、0.916、0.949,均＞0.9,预测价值均理想。结论 肝硬化患者血清与腹水中PCT、IL-17水平过表达与其并发自发性腹膜炎密切相关,可用于早期自发性腹膜炎的风险预测及诊断,临床可考虑通过早期检测肝硬化患者血清与腹水中PCT、IL-17水平,来预测肝硬化患者合并自发性腹膜炎风险或诊断疾病的发生,这对早期疾病的风险预测、检出及干预均有重要意义。

Objective To observe the procalcitonin (PCT) and interleukin-17 (IL-17) levels in serum and ascites in liver cirrhosis patients with spontaneous peritonitis, and to analyze the value of PCT and IL-17 levels in serum and ascites in the diagnosis of liver cirrhosis with spontaneous peritonitis. Methods The retrospective analysis was performed, and the medical data of 110 patients with liver cirrhosis who admitted in the hospital from September 2017 to September 2019 were collected. The patients were effectively divided into groups according to whether they had spontaneous peritonitis, 40 patients without spontaneous peritonitis were included in the control group, and 70 patients with spontaneous peritonitis were included in the observation group. The levels of PCT and IL-17 in serum and ascites were compared between the two groups, and the correlation between PCT and IL-17 was analyzed by bivariate Pearson linear correlation. The relationship between PCT and IL-17 in serum and ascites and spontaneous peritonitis in patients with liver cirrhosis and its value in the diagnosis of liver cirrhosis complicated by spontaneous peritonitis were analyzed. Results The PCT and IL-17 levels in serum and ascites in observation group were higher than those in control group (P<0.05); Bivariate Pearson linear correlation test results showed that PCT was positively correlated with IL-17 level in serum (r=0.707, P<0.001), and PCT was positively correlated with IL-17 level in ascites (r=0.675, P<0.001); Taking whether liver cirrhosis patients complicated with spontaneous peritonitis as the dependent variables, and PCT and IL-17 in serum and ascites were taken as independent variables, the bivariate Logistic correlation analysis showed that over-expression of PCT and IL-17 levels in serum and ascites may be the main factors causing spontaneous peritonitis in patients with liver cirrhosis (OR>1, P<0.05); Taking the PCT and IL-17 levels in serum and ascites as test variables, and whether liver cirrhosis patients complicated by spontaneous peritonitis was taken as the state variables, the ROC curve showed that the AUC of PCT and IL-17 levels in serum and ascites in predicting liver cirrhosis patients complicated by spontaneous peritonitis was: 0.973, 0.950, 0.916, 0.949, respectively, all of which were greater than 0.9, and the prediction value was ideal. Conclusion The over-expression of PCT and IL-17 levels in the serum and ascites of patients with liver cirrhosis is closely related to their concurrent spontaneous peritonitis, which can be used for the risk prediction and diagnosis of early spontaneous peritonitis. Clinically, early detection of PCT and IL-17 levels in the serum and ascites in patients with liver cirrhosis can be considered to predict the risk of spontaneous peritonitis or diagnose the disease in patients with liver cirrhosis, which is of great significance for the risk prediction, detection and intervention of early disease.