摘要
目的探讨血清总胆红素(T-Bil)、红细胞沉降率(ESR)和C反应蛋白(CRP)检测对老年不典型性腹膜透析相关性腹膜炎(PDRP)的价值。方法选取新乡医学院第一附属医院肾内科病房2015年1月至2019年12月29例老年不典型性PDRP患者为观察组,同期未发生腹膜炎且资料齐全的老年腹膜透析患者85例为对照组,对比两组患者血清T-Bil、ESR和CRP水平,运用受试者工作特征(ROC)曲线,分析各检测指标对老年不典型性PDRP的诊断价值。结果(1)观察组T-Bil水平低于对照组,ESR和CRP水平高于对照组,差异有统计学意义(均P<0.05)。(2)T-Bil用于老年不典型性PDRP的ROC曲线下面积为0.664(95%CI:0.538~0.790)。以最大约登指数(即敏感性联合特异性-1)作为最佳界值的甄选标准,则T-Bil≤6.55μmol·L^-1是诊断老年不典型性PDRP的最佳诊断界值,相应的敏感度和特异度分别为77.60%和52.20%。(3)ESR用于老年不典型性PDRP的ROC曲线下面积为0.750(95%CI:0.606~0.893),敏感度和特异度分别为60.90%和88.00%。CRP用于老年不典型性PDRP的ROC曲线下面积为0.895(95%CI:0.806~0.983),敏感度和特异度分别为87.00%和85.20%。ESR和CRP联合检测,用于老年不典型性PDRP的ROC曲线下面积为0.935(95%CI:0.889~0.980),敏感度和特异度分别为96.00%和87.00%。结论血清T-Bil、ESR和CRP均对老年不典型性PDRP有一定的诊断价值。
Objective To explore the clinical values of serum total bilirubin(T-Bil),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in the elderly patients with atypical peritoneal dialysis-related peritonitis(PDRP).Methods Twenty-nine elderly(>60 years old)inpatients with atypical PDRP in the First Affiliated Hospital of Xinxiang Medical University from January 2015 to December 2019 were collected as the observed group,other 85 elderly cases without peritonitis as the control group.The levels of T-Bil,ESR and CRP were compared between the two groups,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of each test serum index for atypical PDRP.Results(1)The level of serum T-Bil in the observed group was lower than that in the control group,the levels of serum ESR and CRP were higher in the observed group than those in the control group(all P<0.05).(2)The area under the curve of ROC for serum T-Bil was 0.664(95%CI:0.538-0.790)in the prediction of atypical PDRP in the elderly patients.Taking the maximum Youden index(sensitivity and specificity-1)as the selection standard of the best boundary value,T-Bil≤6.55μmol·L^-1 was the best boundary value for the diagnosis of atypical PDRP in the elderly patients,the corresponding sensitivity and specificity were 77.60%and 52.20%respectively.(3)The area under the curve for serum ESR was 0.750(95%CI:0.606-0.893),the sensitivity and specificity were 60.90%and 88.00%respectively.The area under the curve for serum CRP was 0.895(95%CI:0.806-0.983),the sensitivity and specificity were 87.00%and 85.20%respectively.The area under the curve for ESR and CRP was 0.935(95%CI:0.889-0.980),the sensitivity and specificity were 96.00%and 87.00%respectively.Conclusion Serum T-Bil,ESR and CRP have certain diagnostic value for atypical peritoneal dialysis-related peritonitis in elderly patients.
作者
马东红
黎妞
吕玉敏
曹子彧
王路路
刘云
郭明好
MA Dong-hong;LI Niu;LU Yu-min;CAO Zi-yu;WANG Lu-lu;LIU Yun;GUO Ming-hao(Department of Nephrology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)
出处
《河南医学研究》
CAS
2020年第26期4815-4819,共5页
Henan Medical Research
基金
河南省科技厅重点研发与推广项目(182102310585)
河南省卫生厅科技攻关省部共建备选项目(2018010013)。
关键词
腹膜透析相关性腹膜炎
老年人
总胆红素
红细胞沉降率
C反应蛋白
peritoneal dialysis-related peritonitis
elderly
total bilirubin
erythrocyte sedimentation rate
C-reactive protein
