Prognostic value of immune cell changes in ascites for spontaneous bacterial peritonitis in cirrhotic patients with ascites
Objective:The predictive value of analyzing changes in lymphocyte like cell subpopulations in ascites for spontaneous bacterial peritonitis(SBP)in patients with cirrhosis and ascites.Methods:Collect clinical data of 279 patients with liver cirrhosis and ascites who treatment in our hospital from January 2020 to January 2023.Using the random number method,the visiting patients were divided into a training set(186 cases)and a validation set(93 cases)in a two∶one ratio,respectively,to construct a risk model for patients with SBP and validate the model.The training set patients were divided into an SBP group(52 cases)and a non SBP group(134 cases)based on whether SBP occurred.Compare the clinical data and changes in lymphoid cell subpopulations in ascites between two groups of patients,and analyze the influencing factors for the occurrence of SBP in patients.The predictive value of using ROC curve to evaluate changes in lymphoid cell subpopulations in ascites for the occurrence of SBP in patients.Constructing an artificial neural network model;And verify the effectiveness of the model.Results:Compared with the non SBP group,there was no statistically significant difference in CD3+T cells between the SBP group after three days of treatment and the end of treatment(P>0.05).CD8+ T cells and B cells were significantly reduced,while the ratio of CD4+T cells,CD4+/CD8+,and NK cells was significantly increased(P<0.05).The results of multivariate analysis showed that Child-pugh grade,upper gastrointestinal bleeding,peripheral blood WBC,serum TBIL,ascitic fluid ALB concentration,after treatment CD4+ T cells,CD8+T cells,CD4+/CD8+ ratio,B cells,and NK cells were all independent risk factors for SBP in patients with cirrhosis ascites(P<0.05).The changes in lymphocyte like cell subpopulations in ascites have certain predictive value for the occurrence of SBP in patients,and the combined detection of various indicators has higher predictive value(AUC =0.813).The areas under the curve of the ROC type in the training and validation sets were 0.875(95%CI:0.824-0.926,P<0.001)and 0.819(95%CI:0.756-0.882,P<0.001),respectively.The specificity was 94.51%and 92.04%,respectively;The sensitivity is 93.73%and 91.62%respectively,indicating that the artificial neural network prediction model has good discrimination.Conclusion:Child-pugh grading,upper gastrointestinal bleeding,peripheral blood WBC,serum TBIL,ascitic ALB concentration,after treatment CD4+T cells,CD8+T cells,CD4+/CD8+ratio,B cells,and NK cells are all independent risk factors for SBP in patients with cirrhosis ascites.The changes in lymphocyte like cell subpopulations in ascites have certain predictive value for the occurrence of SBP in patients with cirrhosis ascites.
lymphoid cell subpopulationcirrhotic ascitesspontaneous bacterial peritonitispredictive value
万方数据
维普
