Analysis Of Beneficial Related Factors For Diagnosing The Liver Cirrhosis Complicated With Spontaneous Bacterial Peritonitis

Objective:The incidence rate and the case fatality of liver cirrhosiscomplicated with spontaneous bacterial peritonitis(SBP) is very high inclinic. The patients with liver cirrhosis complicated with SBP especiallythese whose ascites bacterial culture and ascites leucocyte inspectionare negative,but only with the clinical symptoms and signs were easilymisdiagnosed and easily missed diagnosis.The article aims to study andanalyze the beneficial related factors for diagnosing the liver cirrhosiscomplicated with SBP, which are helpful to improve the level of theknowledge and diagnosis and treatment of the disease, to reduce themortality of the disease and improve the prognosis of patients.Methods:To discuss the beneficial related factors fordiagnosing the liver cirrhosis complicated with SBP,114patientswith liver cirrhosis complicated with SBP hospitalized between January2012and September2013in department of Hepatic-Biliary-Pancreaticmedicine in the first hospital of Ji lin university were selected,and114patients with liver cirrhosis ascites but not complicated with SBP wereselected randomly at the same time; The patient’s clinical data werestudied by retrospective analysis, and the patient’s age, gender, etiology, history of bleeding and ascites,serum biochemistry examination, Child-Pugh grading,complications of the two groups were compared byunivariate analysis and multivariate analysis of binary logisticregression.Results:(1)There were79patients with fever,38patients withabdominal pain,68patients with abdominal tenderness,37patients withabdominal rebound tenderness,26patients with diarrhea,20patientswith abdominal muscle tension in the114patients with SBP.(2)Therewere79patients with ascites white blood cells>500×106/L,46patientswith ascites germiculture positive in the114patients with SBP.56strains of bacteria were cultivated in total,37strains of gram-negativebacteria,19strains of gram-positive bacterium and no fungus amongthem.(3)Statistical differences were showed when compared withhistory of ascites, TBIL,CHE,PT,PTA,WBC,NE%, Child-Pugh grading,hepatic encephalopathy and hyponatremia between the two groups byunivariate analysis,but not when compared with age,gender, etiology,history of bleeding, AST, ALT, ALP, GGT,ALB, BUN,Cr,upper gastro-intestinal bleeding and Hepatorenal syndrome.(4) Child-Pugh grading,history of ascites,WBC were showed to be beneficial related factors fordiagnosing the liver cirrhosis complicated with SBP by multivariateanalysis. Conclusions:(1)Most patients with SBP in the study had atypicalclinical manifestations, the most common manifestations were fever,abdominal tenderness, the second were abdominal pain, abdominalrebound tenderness, diarrhea, abdominal muscle tension,which hadcertain implications for diagnosing the liver cirrhosis complicated withSBP.(2)Most of the pathogenic bacteria were still gram-negativebacteria in the114patients with SBP,but the number of gram positivebacteria increased,The ascites germiculture positive rate and the asciteswhite blood cells’s sensitivity of diagnosing the SBP were not high.(3)Hepatic encephalopathy, hyponatremia, history of ascites, TBIL,CHE,PT,PTA,WBC,NE%and Child-Pugh grading were showed to bebeneficial related factors for diagnosing the liver cirrhosis complicatedwith SBP by univariate analysis.(4)High Child-Pugh grading,history ofascites,high level of WBC were showed to be three separate beneficialrelated factors for diagnosing the liver cirrhosis complicated with SBPby multivariate analysis,in other words,these patients with livercirrhosis ascites who had high Child-Pugh grading or history of ascitesor high ascites protein level were advantageous to be diagnosed withliver cirrhosis complicated with SBP.(5)The selected cases of the studywere less,and other significant factors could be missed，therefore,further research should focus on attention to the quality of the retrospective study,and multicenter study or liver cirrhosis crowd’sprospectie cohort study should be used to increase the credibility ofresearch conclusion.