Value of heparin-binding protein in ascites and serum procalcitonin in diagnosis of spontaneous bacterial peritonitis

Objective To investigate the value of heparin-binding protein (HBP) in ascites combined with serum procalcitonin (PCT) in the diagnosis of spontaneous bacterial peritonitis (SBP) . Methods A total of 120 patients with ascites who were hospitalized in our hospital from January 2016 to June 2018 were enrolled and divided into cirrhotic ascites + SBP group with 40 patients, leaky ascites group with 40 patients, malignant ascites group with 20 patients, and tuberculous ascites group with 20 patients. Bacterial culture of ascites was performed for all patients, and polymorphonuclear leukocyte (PMN) count in ascites, HBP in ascites, and serum PCT level were measured and analyzed.The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between multiple groups; non-normally distributed continuous data were expressed as median [M (P25, P75) ], and the Kruskal-Wallis H test was used for comparison between multiple groups and the Nemenyi test was used for comparison between two groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of HBP in ascites and serum PCT, and the Spearman correlation analysis was used to investigate the correlation between HBP in ascites and serum PCT. Results The cirrhotic ascites + SBP group had significant increases in the levels of HBP in ascites and serum PCT compared with the leaky ascites group, the malignant ascites group, and the tuberculous ascites group (P < 0. 05) . There was no significant difference in HBP level in ascites between patients with different bacteria determined by bacterial culture of ascites (P > 0. 05) , and there was also no significant difference in HBP level in ascites between patients with positive or negative results of bacterial culture of ascites (58. 59 ± 36. 23 ng/ml vs 63. 61 ±32. 54 ng/ml, t = 1. 763, P > 0. 05) . Serum PCT had an optimal cut-off value of 0. 62 ng/ml in the diagnosis of SBP, with an area under the ROC curve of 0. 831, a sensitivity of 86. 3%, and a specificity of 52. 8%. HBP in ascites had an optimal cut-off value of 23. 54 ng/ml in the diagnosis of SBP, with an area under the ROC curve of 0. 962, a sensitivity of 92. 3%, and a specificity of 65. 4%. Ascites HBP was highly correlated with serum PCT (r = 0. 776, P < 0. 05) . Conclusion The level of HBP in ascites has a high value in the diagnosis of SBP, and combined measurement of ascites HBP and serum PCT can improve the diagnostic efficiency of SBP.