腹水多形核细胞计数联合全身免疫炎症指数和血清CRP/ALB比值诊断失代偿期肝硬化患者并发自发性细菌性腹膜炎价值研究*

doi:10.3969/j.issn.1672-5069.2025.06.019

Abstract

Abstract: Objective The aim of this study was to explore the predictive efficacy of ascites polymorphonuclear leucocyte (PMN) counts and systemic immune-inflammation index (SII) and serum C-reactive protein (CRP)/albumin (ALB) ratio for spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis. Methods 80 patients with decompensated liver cirrhosis were admitted to our hospital between April 2021 and April 2025, blood and ascites routine, blood biochemical and serum CRP levels were obtained clinically, and SII and CRP/ALB ratio were calculated. The predictive efficacy was analyzed by using multivariate Logistic regression and receiver operating characteristic (ROC) curves. Results Of the 80 patients with decompensated liver cirrhosis, SBP was diagnosed in 31 cases(38.8%); percentage of Child-Pugh class C, hepatic encephalopathy and varices bleeding in SBP group were 51.6%, 22.6% and 45.2%, all much higher than 10.2%, 0.0% and 0.0% (P＜0.0) in non-SBP group; prothrombin time, serum albumin levels and peripheral white blood cell counts in SBP group were (14.3±3.1) s, (29.7±0.5) g/L and (9.8±2.6)×10⁹/L, all significantly different as compared to [(12.9±2.9) s,(36.9±8.1) g/L and (7.1±1.9)×10⁹/L, respectively, P＜0.05] in non-SBP group; ascites PMN count, SII and CRP/ALB ratio in patients with SBP were (270.2±70.4)×10⁶/L, (284.1±41.7) and (0.7±0.2), all significantly higher than [(25.6±6.9)×10⁶/L,(221.7±28.9) and (0.4±0.1), respectively, P＜0.05] in those without; Logistic regression analysis showed that ascites PMN, SII and CRP/ALB ratio were all the independent risk factors for SBP occurrence (P＜0.05); ROC analysis demonstrated that the sensitivity was 94.8% and the specificity was 98.0%, when ascites PMN was combined with SII or CRP/ALB ratio in predicting SBP complicated. Conclusion SII and/or CRP/ALB ratio is helpful in preventing underdiagnosis of SBP in patients with decompensated liver cirrhosis, if ascites PMN counts is alone relied on.

Key words: Decompensated liver cirrhosis, Spontaneous bacterial peritonitis, Systemic immune-inflammation index, Polymorphonuclear leucocyte, C-reactive protein /albumin ratio, Diagnosis

Peng Dongmei, Wang Dong, Xie Xiaojun. Predictive efficacy of ascites polymorphonuclear leucocyte counts and systemic immune-inflammation index and serum CRP/ALB ratio for spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis[J]. Journal of Practical Hepatology, 2025, 28(6): 874-877.

References

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Predictive efficacy of ascites polymorphonuclear leucocyte counts and systemic immune-inflammation index and serum CRP/ALB ratio for spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis

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