Clinical values of multi-marker combined detection for early diagnosis of infection in patients with liver cirrhosis / 第二军医大学学报

ABSTRACT

Objective To analyze the clinical values of combined detection of procalcitonin (PCT), interleukin-6 (IL-6), C-reaction protein (CRP), neutrophil CD64, white blood cell (WBC) count and neutrophil ratio for diagnosis of infection in patients with liver cirrhosis. Methods The hospitalized patients with liver cirrhosis were divided into the infection group and the non-infection group according to the bacterial culture and clinical symptoms. The serum levels of PCT and IL-6 were detected by Chemiluminescence immunoassay. The serum CRP was detected by biochemistry analyzer. The neutrophil CD64 was detected by flow cytometer, and WBC count and neutrophil ratio were detected by blood cell analyzer. The collected data were analyzed by logistic regression and receiver operating characteristic (ROC) curves. ResultsAll the markers in the infection group were higher than those in the non-infection group (P<0.01). The results of logistic regression analysis showed that PCT, IL-6 and neutrophil CD64 could predict the infection in patients with liver cirrhosis,with the odd ratio being 7.199 (95%CI, 2.180-23.771),1.010 (95%CI,1.002-1.017)and 2.312 (95%CI,1.485-3.600), respectively. However, CRP, WBC count and neutrophil ratio showed no predictive values. The ROC curves showed that the area under curves (AUC) of PCT, IL-6 and neutrophil CD64 were 0.791 (95%CI,0.727-0.856),0.762 (95%CI,0.693-0.832)and 0.884 (95%CI,0.835-0.933), respectively. The AUC of combined detection of the three markers was 0.932 (95%CI,0.897-0.967), with a diagnostic accuracy of 86.9%. Conclusion PCT, IL-6 and neutrophil CD64 can predict infection in patients with liver cirrhosis, and combined detection of the three markers can improve the diagnostic efficiency.