比色法早期诊断自发性细菌性腹膜炎。

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101887

Claudia G. Solis-Hernandez, Marycamen Alegria-Ovando, Kenia M. Bastida-Guadarrama, F. Yael Duran-Vargas, Paola Zuñiga-Escobedo, Monica Garcia-Baca, D. Ernestina Espinoza-Lopez, Rodrigo Toledo-Galvan, Jessica Mejia-Ramirez, Maria F. Higuera de la Tijera, Jose L. Perez-Hernandez

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引用次数: 0

摘要

前言与目的自发性细菌性腹膜炎（SBP）的诊断需要进行生化分析，有时需要较长时间，因此找到一种有效、快速的方法可以缩短开始使用抗菌药物的时间，降低并发症的发生风险。目的：验证比色法（试剂条）对收缩压的诊断价值。材料和患者比色法诊断PBE的观察性、保护性和分析性研究。对疑似PBE患者进行诊断性穿刺，通过任务试纸的比色比例尺分析液体，并与实验室的细胞化学分析进行比较（多形核≥250个细胞/mm³）。为了评估试纸作为诊断试验，使用试纸读数≥15个白细胞的截止点。2 × 2表用于比较细胞化学和试纸法的PBE阳性和阴性。计算S、E、PPV和NPV。结果共纳入42例腹水伴怀疑收缩压患者。其中Child-Pugh C期24例（57.14%），Child-Pugh B期17例（40.27%），Child-Pugh a期仅1例（2.38%）。慢性肝病的病因为饮酒17例（40.27%），MASLD 15例（35.71%），自身免疫性肝病4例（9.52%），非相关病因4例（9.52%），丙型肝炎病毒继发感染2例（4.76%）。其中女性23例（54.7%），平均年龄54岁（SD±12.06）。13例患者被诊断为PBE，其中81%为II级腹水。与细胞化学法相比，该试纸的敏感性为92.3%，特异性为86.2%，阳性预测值（PPV）为99.4%，阴性预测值（NPV）为98.6%。结论荧光比色法（试纸条）具有足够的敏感性和特异性，是一种低成本、易于使用、快速解释的工具，可用于腹水和自发性细菌性腹膜炎患者早期启动抗菌药物治疗。虽然样本很小，但它显示了一个值得证实的有趣趋势。

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Colorimetric test for early diagnosis of spontaneous bacterial peritonitis.

Introduction and Objectives

The diagnosis of spontaneous bacterial peritonitis (SBP) requires biochemical analysis that can sometimes take time, so having an effective and rapid method could shorten the time to start the antimicrobial and reduce the risk of complications. Objective: To validate the colorimetric test (reagent strips) in the diagnosis of SBP.

Materials and Patients

Observational, prolective, and analytical study of the colorimetric test for the diagnosis of PBE. Diagnostic paracentesis was performed in patients with suspected PBE, for the analysis of the fluid by means of the colorimetric scale of the Mission test strip and compared with the cytochemical analysis in the laboratory (polymorphonuclear ≥ 250 cells/mm³). To assess the test strip as a diagnostic test, a cut-off point of strip reading ≥15 leukocytes is used. A 2 × 2 table is used to compare the positives and negatives of PBE by both cytochemical and dipstick methods. S, E, PPV and NPV were calculated.

Results

42 patients with ascites and suspected SBP were included. Of these, 24 patients (57.14%) were in Child-Pugh stage C, 17 patients (40.27%) were in Child-Pugh stage B and only 1 patient (2.38%) was in Child-Pugh stage A. The causes of chronic liver disease were alcohol consumption in 17 patients (40.27%), MASLD in 15 patients (35.71%), autoimmune liver disease in 4 patients (9.52%), unaffiliated etiology in 4 patients (9.52%), infection secondary to hepatitis C virus in 2 patients (4.76%). Of the total, 23 patients (54.7%) were female with a mean age of 54 years (SD ± 12.06). Thirteen patients were diagnosed with PBE, 81% of them with grade II ascites. The sensitivity of the dipstick compared to the cytochemical method was 92.3%, its specificity 86.2%, its positive predictive value (PPV) 99.4%, and its negative predictive value (NPV) 98.6%.

Conclusions

Colorimetry (test strips) show adequate sensitivity and specificity, making them a low-cost, easy-to-use, but above all quick to interpret tool for early initiation of antimicrobial therapy in patients with ascites and spontaneous bacterial peritonitis. Although the sample is small, it shows an interesting trend that should be confirmed.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.