The Value Of Intravenous Albumin In Spontaneous Bacterial Peritonitis Treatment

BACKGROUND:Spontaneous bacterial peritonitis (SBP) is a common complication of livercirrhosis. Patients suffering from liver cirrhosis and SBP turn out to be easy tocomplicate with HRS (hepato renal syndrome) which leads to a high mortalityrate. We conducted a study to assess whether the administration of albuminprevents HRS and reduces mortality rate, as well as to explore the influence ofdifferent doses of intravenous albumin on disease outcome, by contrastingpatients’ condition after anti-infection only and anti-infection plus intravenousalbumin in different doses.METHORDSThis study investigated75cases of patients who were diagnosed as livercirrhosis and SBP in China-Japan United Hospital during2006and2014. Weassigned all the patients to3subgroups. Group1had24cases, these patientswere treated with anti-infection and standard dose of albumin (1.5g/Kg at thetime of diagnosis, followed by1.0g/Kg on day3). Group2had25cases, theywere treated with anti-infection and smaller dose of albumin (1.0g/Kg at the timeof diagnosis, followed by0.5g/Kg on day3). Group3had26cases, they weretreated with anti-infection without albumin. Analyzed and contrasted all patients’clinical features and prognosis after different treatments. A90days follow-upvisit was set up, too. SPSS (Statistical Package for the Social Sciences) l7.0statistical software was applied to analyze test data, With t test or chi-squareanalysis accordingly (P <0.05is considered to be statistically significant).RESULTS:SBP were resolved in all patients. ALOS(the average length of stay) of patients in Group1and Group2were shorter than ALOS of patients in Group3,P <0.05. Blood urea nitrogen and creatinine of patients in both Group1andGroup2were lower than that in Group3, P<0.05. Rate of disease progression inGroup1was20.8%（5/24），in Group2was24.0%（6/25）, those were lower thanrate of disease progression in Group3(53.8%,14/26）,P<0.05. The rate ofreadmission of patients in Group1and Group2were lower than that in Group3,P<0.05.The serum total bilirubin and Child-pugh score of patients in Group1and Group2were lower than which in Group3, P<0.05. The serum albumin inGroup1(30.3±4.1g) was higher than Group3（26.8±5.8g）, P value was0.02.CONCLUSION:Albumin infusion can shorten SBP patients’ ALOS and reduce patients’rate of disease progression, as well as rate of readmission. The administration ofalbumin can improve Child-pugh score, too. Smaller dose of albumin worksalmost as well as standard dose of albumin in reducing HRS, improving liverfunction, reducing rate of disease progression and reducing rate of readmission.