失代偿期肝硬化并发自发性细菌性腹膜炎患者血清sTREM-1和PCT水平变化及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2026.02.027

摘要/Abstract

摘要： 目的探讨失代偿期肝硬化并发自发性细菌性腹膜炎(SBP)患者血清可溶性髓系细胞触发受体-1(sTREM-1)和降钙素原(PCT)水平及外周血中性粒细胞(NEU)占比变化及其临床意义。方法 2022年1月～2025年1月我院收治的132例肝硬化患者,接受常规支持治疗或/和抗感染治疗。采用ELISA法检测血清sTREM-1和PCT水平。结果在本研究纳入的132例患者中, 诊断SBP 63例(47.7%);SBP组肝功能Child-Pugh C级占比、INR、外周血白细胞计数和腹水有核细胞计数水平均显著高于无SBP组(P<0.05),而血清白蛋白水平显著低于无SBP组(P<0.05);SBP组血清sTREM-1和PCT及NEU占比分别为(168.3±19.8)pg/mL和(3.6±1.0)ng/mL及(88.9±6.7)%,均显著高于无SBP组【分别为(126.2±22.4)pg/mL和(0.1±0.1)ng/mL及(72.7±5.3)%,P<0.05】;在治疗2周末,58例(92.1%)获得感染控制;有效组血清sTREM-1和PCT水平和NEU占比显著降低(P<0.05),4例死亡,1例腹腔感染反复发作,病情迁延。结论失代偿期肝硬化并发SBP患者血清sTREM-1和PCT水平异常升高,监测这些指标可能有助于评估抗感染治疗疗效,为临床治疗决策提供参考依据。

关键词: 失代偿期肝硬化, 自发性细菌性腹膜炎, 可溶性髓系细胞触发受体-1, 降钙素原, 转归

Abstract: Objective The aim of this study was to investigate the changes of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and procalcitonin (PCT) levels in patients with decompensated liver cirrhosis (DLC) complicated with spontaneous bacterial peritonitis (SBP) . Methods 132 patients with cirrhotic ascites were enrolled in our hospital between January 2022 and January 2025, and all received antibiotics and general supporting therapy. Serum sTREM-1 level were detected by ELISA, and serum and PCT level were routinely obtained. Results Of 132 patients with DLC in our series, SBP was found in 63 cases (47.7%); percentage of Child-Pugh class C, INR, peripheral white blood cell count and ascites polymorphonuclear leukocyte cell count in patients with SBP were much higher(P<0.05), while serum albumin level was much lower than in those without(P<0.05); serum sTREM-1 and PCT levels as well as percentage of blood leukocytes in patients with SBP were (168.3±19.8)pg/mL, (3.6±1.0)ng/mL and (88.9±6.7)%, all much higher than [(126.2±22.4)pg/mL, (0.1±0.1)ng/mL and (72.7±5.3)%, respectively, P<0.05] in those without; by end of two-week treatment, 58 patients(92.1%) recovered with peritoneal infection controlled, and serum sTREM-1 and PCT levels decreased to normal(P<0.05), while 4 patients died and 1 patient had his SBP protracted. Conclusion Serum sTREM-1 and PCT levels in patients with DLC and SBP are abnormally elevated, and surveillance of them might monitor infection states and help assess the prognosis.

Key words: Decompensated liver cirrhosis, Spontaneous bacterial peritonitis, Soluble triggering receptor expressed on myeloid cells-1, Procalcitonin, Outcomes

李艳慧, 张效良, 李兰花. 失代偿期肝硬化并发自发性细菌性腹膜炎患者血清sTREM-1和PCT水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2026, 29(2): 269-272.

Li Yanhui, Zhang Xiaoliang, Li Lanhua. Clinical implication of serum sTREM-1 and PCT levels in patients with decompensated liver cirrhosis complicated with spontaneous bacterial peritonitis[J]. Journal of Practical Hepatology, 2026, 29(2): 269-272.

参考文献

[1] 沈莉莉,赵琳,石磊.失代偿期乙型肝炎肝硬化并发自发性细菌性腹膜炎患者第三代头孢菌素类耐药情况调查.实用肝脏病杂志,2025,28(1):88-91.
[2] Helil AS, Haile SA, Birhanu Y, et al. Bacterial profile, drug resistance pattern, clinical and laboratory predictors of ascites infection in cirrhosis patients. BMC Infect Dis, 2024, 24(1): 528.
[3] YinX, Qin E, Song R, et al. Diagnostic model for spontaneous bacterial peritonitis in cirrhotic patients with ascites: a multicenter cohort study. Eur J Gastroenterol Hepatol, 2024, 6(11):1319-1328.
[4] Meng D, Yang H, Zhang XQ, et al. Heme oxygenase-1 as a predictive marker for spontaneous bacterial peritonitis in cirrhotic patients with ascites. Ann Clin Lab Sci, 2023, 53(3):448-456.
[5] Wei Y, Xiao P, Wu B, et al. Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction. Open Life Sci, 2023, 18(1):20220639.
[6] 姚岚,郭菲,宋莉,等.颅脑手术后院内并发颅内感染患者脑脊液中病原菌分布及炎症相关指标动态变化情况与相关诊断价值分析.中华神经外科疾病研究杂志,2025,19(4):120-125.
[7] 徐小元,丁惠国,李文刚,等.肝硬化腹水及相关并发症的诊疗指南.实用肝脏病杂志,2018,21(1):21-31.
[8] 中华医学会消化病学分会.中国肝硬化临床诊治共识意见.临床肝胆病杂志,2023,39(9):2057-2073.
[9] Xu X, Ding H, Jia J, et al. Chinese guidelines on the management of ascites in cirrhosis : Chinese society of hepatology, Chinese medical association. Hepatol Int, 2024, 18(4):1071-1089.
[10] Zheng X, Wei W. Ascites complications risk factors of decompensated cirrhosis patients: logistic regression and prediction model. BMC Gastroenterol, 2025, 25(1):397.
[11] 王本贤,李伟,李东生,等.腹水浓缩回输联合抗感染治疗失代偿期乙型肝炎肝硬化患者疗效研究.实用肝脏病杂志,2022,25(2):247-250.
[12] Würstle S, Schneider T, Karapetyan S, et al. LINAS-score: prognostic model for mortality assessment in patients with cirrhotic liver and infected ascites. J Gastroenterol Hepatol, 2024, 39(9):1876-1884.
[13] Tang D, Ge H, Tan Z, et al. The Factors for the occurrence of pulmonary infection after gastrointestinal surgery and the construction of a predictive model using sTREM-1 and TIM-4: a retrospective study. Ann Ital Chir, 2024, 95(3):299-307.
[14] Yadav P, Trehanpati N, Maiwall R,et al. Soluble factors and suppressive monocytes can predict early development of sepsis in acute-on-chronic liver failure. Hepatol Commun, 2022, 6(8):2105-2120.
[15] Wu X, Zhao W, Miao Q, et al. CCR2⁺TREM-1⁺ monocytes promote natural killer T cell dysfunction contributing towards HBV disease progression. Immunol Res, 2024, 72(5):938-947.
[16] Abu Rahma MZ, Mahran ZG, et al. The role of serum procalcitonin level as an early marker of ascitic fluid infection in post hepatitic cirrhotic patients. Antiinflamm Antiallergy Agents Med Chem, 2021, 20(1):61-67.
[17] Mousa N, Salah M, Elbaz S, et al. Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study. Gut Pathog, 2024, 16(1):18.
[18] Tornai D, Vitalis Z, Jonas A, et al. Increased sTREM-1 levels identify cirrhotic patients with bacterial infection and predict their 90-day mortality. ClinRes Hepatol Gastroenterol, 2021, 45(5):101579.
[19] Farah R, Jacoby T, Khamisy-Farah R. Neutrophil-to-lymphocyte ratio, c-reactive protein, and mean platelet volume in differentiation of ascites causes. Isr Med Assoc J, 2025, 27(4):211-215.
[20] 林晓宇,李琛,张婷,等.肝硬化门静脉高压症患者肠壁屏障功能的改变及其与易发感染的关系.中华肝脏病杂志,2023,31(1):70-76.
[21] Wirtz TH, Reuken PA, Jansen C, et al. Balance between macrophage migration inhibitory factor and sCD74 predicts outcome in patients with acute decompensation of cirrhosis. JHEP Rep, 2020, 3(2):100221.
[22] Du T,Li QP, Jiang GX, et al. Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes. BMC Infect Dis, 2023, 23(1):786.
[23] Kumar D, Kumar V, Khan RTY, et al. Predictors of mortality in patients with spontaneous bacterial peritonitis. Euroasian J Hepatogastroenterol, 2024, 14(2):125-128.

失代偿期肝硬化并发自发性细菌性腹膜炎患者血清sTREM-1和PCT水平变化及其临床意义探讨^*

Clinical implication of serum sTREM-1 and PCT levels in patients with decompensated liver cirrhosis complicated with spontaneous bacterial peritonitis

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