METHODS: In this cohort study, 60 patients with liver cirrhosis and ascites accompanied by SBP (studied cohort, n=26) or not (control cohort, n=34) were retrospectively included. HO-1 levels in the serum and ascites were detected by ELISA. The predictive performance of HO-1 was evaluated by calculating the area under the curve (AUC) in receiver operating characteristic (ROC) curve analysis.
RESULTS: The HO-1 level of SBP patients was significantly higher than that of non-SBP patients both in the serum and ascites (p<0.001). Serum, ascites HO-1, and their combination displayed an AUC of 0.897 (95% CI, 0.808-0.986), 0.825 (95% CI, 0.708-0.941), and 0.902 (95% CI, 0.817-0.986) for discriminating SBP from non-SBP patients. HO-1 level between serum and ascites had a higher correlation in patients in a Child-Pugh B stage (R=0.691, p<0.001) than in the Child-Pugh C stage (R=0.475, p=0.014). The correlation between HO-1 level and inflammatory factors or biochemical parameters was observed in SBP patients and presented in a Child-Pugh stage-dependent manner.
CONCLUSIONS: HO-1 level has the ability to predict the occurrence of SBP in cirrhotic patients with ascites which has the potential to be a biomarker for the early prediction of SBP and move into the clinical setting. However, the Child-Pugh stage should be considered when using the HO-1 as a predictive biomarker.
方法:在这项队列研究中,60例肝硬化腹水伴SBP患者(研究队列,n=26)或不(对照组,n=34)被回顾性纳入。ELISA法检测血清和腹水中的HO-1水平。通过计算受试者工作特征(ROC)曲线分析中的曲线下面积(AUC)来评估HO-1的预测性能。
结果:SBP患者血清和腹水中的HO-1水平均明显高于非SBP患者(p<0.001)。血清,腹水HO-1及其组合显示AUC为0.897(95%CI,0.808-0.986),0.825(95%CI,0.708-0.941),和0.902(95%CI,0.817-0.986)用于区分SBP与非SBP患者。血清和腹水之间的HO-1水平在Child-PughB期(R=0.691,p<0.001)患者中的相关性高于Child-PughC期(R=0.475,p=0.014)。在SBP患者中观察到HO-1水平与炎症因子或生化指标之间的相关性,并以Child-Pugh分期依赖性方式呈现。
结论:HO-1水平具有预测肝硬化腹水患者SBP发生的能力,有可能成为早期预测SBP的生物标志物并进入临床环境。然而,使用HO-1作为预测生物标志物时,应考虑Child-Pugh阶段.