不同炎症因子对肝硬化腹水并发腹腔感染的预测效能研究

Predictive efficacy of different inflammatory factors on ascites complicated by abdominal infection in liver cirrhosis

摘要:

目的 观察不同炎症因子对肝硬化腹水并发腹腔感染的预测效能。方法 该文为回顾性研究，病例纳入郑州大学第一附属医院2022年1月至2023年6月收治的118例肝硬化腹水患者，根据是否合并腹腔感染，将入组患者分为感染组（48例）和未感染组（70例），收集、对比两组患者的一般资料、临床资料，经统计学单因素分析、Logistic多因素回归分析归纳导致肝硬化腹水患者并发症腹腔感染的危险因素，经Spearman相关性系数检验各炎症因子与肝硬化腹水并发腹腔感染的相关性，通过绘制受试者工作特征（ROC）曲线并观察曲线下面积（AUC）分析各炎症因子对肝硬化腹水并发腹腔感染的预测效能。结果 统计学单因素分析结果显示，感染组的吸烟饮酒史、抗病毒治疗等一般资料以及炎症因子、免疫指标等临床资料与未感染组比较差异有统计学意义（P<0.05）；Logistic多因素回归分析结果显示，白细胞介素-6（IL-6）≥7 pg/mL、降钙素原（PCT）≥5 mg/L、血清淀粉样蛋白A（SAA）≥35 mg/L、T淋巴细胞亚群CD3⁺/CD4⁺≥40%、CD4⁺/CD8⁺≥1.5%为导致肝硬化腹水并发腹腔感染的危险因素。经Spearman相关性系数检验，IL-6、PCT、SAA等炎症因子与肝硬化腹水的腹腔感染率正相关。经ROC曲线验证得知，IL-6、PCT、SAA表达越高，肝硬化腹水并发腹腔感染的风险越高。结论 IL-6、PCT、SAA等炎症因子水平升高所致免疫紊乱为导致肝硬化腹水并发腹腔感染的危险因素，通过动态监测IL-6、PCT、SAA能实现对腹腔感染的有效预测。

Abstract:

Objective To observe the predictive efficacy of different inflammatory factors on ascites complicated by abdominal infection in liver cirrhosis.Methods This article is a retrospective study, with cases included from January 2022 to June 2023. The study subjects were 118 patients with liver cirrhosis and ascites. According to whether they were complicated with abdominal infection, the enrolled patients were divided into an infected group (48 cases) and an uninfected group (70 cases). General and clinical data of the two groups of patients were collected and compared, and statistical univariate analysis was conducted. Logistic multiple factor regression analysis summarized the risk factors for complications of abdominal infection in patients with liver cirrhosis ascites. Spearman correlation coefficient was used to test the correlation between various inflammatory factors and the occurrence of abdominal infection in liver cirrhosis ascites. Receiver operating characteristic (ROC) curve was plotted and area under the curve (AUC) analysis was observed to predict the predictive power of various inflammatory factors on the occurrence of abdominal infection in liver cirrhosis ascites.Results The results of statistical univariate analysis showed that there were certain differences in general information such as smoking and drinking history, antiviral treatment, and clinical data such as inflammatory factors and immune indicators between the infected group and the non-infected group (P<0.05). The results of logistic regression analysis showed that IL-6 ≥7 pg/mL, PCT ≥5 mg/L, SAA ≥35 mg/L, CD3⁺/CD4⁺ ≥40%, CD4⁺/CD8⁺ ≥1.5% were risk factors for ascites complicated with abdominal infection in liver cirrhosis. According to Spearman correlation coefficient test, inflammatory factors such as IL-6, PCT, and SAA are positively correlated with the incidence of abdominal infection in cirrhotic ascites. The ROC curve showed that the higher the expression of IL-6, PCT and SAA, the higher the risk of cirrhosis ascites complicated with abdominal infection.Conclusion Immune disorders caused by elevated levels of inflammatory factors such as IL-6, PCT, and SAA are risk factors for liver cirrhosis ascites complicated with abdominal infection. Dynamic monitoring of IL-6, PCT, and SAA can effectively predict abdominal infection.