The Diagnostic Significance of Ascites Procalcitonin in Liver Cirrhosis with Spontaneous Bacterial Peritonitis

Objective: To discuss the clinical value of ascites procalcitonin(PCT) in the diagnosis of decompensated cirrhosis combined with spontaneous bacterial peritonitis(SBP), and determine the reference level of ascites PCT. Methods: 42 patients with liver cirrhosis combined with ascites were enrolled in this study and divided into two groups. In group 1, 22 patients with SBP were enrolled.20 without SBP were enrolled in group 2, and ascite sample were collected at admission, 24 hrs, and 48 hrs after admission. Serum and ascites PCT were measurated by immunochromatographic assay simultaneously, then comparative analysis the level of their changes.Results: The serum and ascite levels of PCT in patients(n=22) with SBP were significantly higher than those without SBP(n = 20)(P0.01); but there is no statistical significance between the ascites and serum level of PCT in patients with SBP(P 0.05). A more sensitive diagnostic role of ascites PCT levels was found compared with serum PCT and ascites cell counts. The AUCs of ROC curve were: at admission: ascites PCT 0.986, serum PCT 0.942 and ascites cell counts 0.868; 24 h after admission: ascites PCT 0.998 and serum PCT0.986; 48 h after admission: ascites PCT 0.986 and serum PCT 0.990. Conclusion: Serum ascites PCT could be used in the diagnosis in liver cirrhosis with SBP, and may be more sensitive than serum PCT and ascites cell counts. The SBP could be diagnosed, if the ascites PCT levels was higher than 0.565 ng/m L(on admission), 0.545 ng/m L(24 h after admission) and 0.410 ng/m L(48 h after admission).