Clinical Research Of Prophylactic Antibiotics For Decompensated Cirrhosis With Pulmonary CT Inflammatory Change

Objective: To investigate the impacts of prophylactic antibiotic therapy fordecompensated cirrhosis with pulmonary CT inflammatory change and Analysis itsrelated factors.Methods:The data of patients with decompensated cirrhosis and pulmonary CTinflammatory of the first affiliated hospital of Fujian medical university wasretrospectively analyzed from Jan. of2008to Sep. of2013. Patients were divided intotwo groups: the antibiotic treatment group and control group. Patients in antibiotictreatment group received preventive antibiotic treatment which was abandoned incontrol group. The general Child-Pugh score and pneumonia incidence werecompared between the two different groups. Moreover the age, gender and grade ofthe Child-pugh (grade B:7-9points, C:10to15points1) were matched betweengroups and the incidence of pulmonary infection was compared. Finally, theinfluencing factors were analyzed. SPSS13.0software was used for statistical analysis,P <0.05was considered to be significant.Result:According to inclusion and exclusion criteria,we included105patients in thisstudy. There was35cases in preventive antibiotic treatment group and70cases incontrol group.(1) There were no significant differences in age, sex between twogroups before intervention(P＞0.05).(2) There are25cases of pulmonary infectionoccurred during the hospitalization. Infection rate was23.8%(8.6%in treatmentgroup vs control group8.6%). There were statistical significance in lung infectionbetween the two groups(χ2=6.720,P=0.010).(3) In Child-Pugh B/C grade、INR <or> 1.5、PLT <or>98×109/L、TBIL <or>54.4umol/L subgroup stratification, it showthe treatment group in lung infection rates significantly lower than the control groupin the Child-Pugh C level, INR>1.5, PLT <98×109/L，TBIL>54.4umol/Lstratified patients, the difference was statistically significant (P <0.05);(4) AverageLength of stay between treatment group and control group was not significant (P=0.587), but the one between infection group and no infection group was statisticallysignificant (P=0.022);(5) Logistic multi-factors analysis results suggest preventiveantibiotic treatment is independent protection factors if the patients decompensatedcirrhosis with pulmonary CT inflammatory change progress to lung infection: the RRvalue of0.095(95%CI:0.018~0.504, P=0.006).(6) Logistic multi-factors analysisresults suggest serum blood lactic acid is one of the important factors associated withinfection: the RR value of0.328(95%CI:0.110~0.978, P=0.045).Logisticmulti-factors analysis results suggest.Conclusions:(1) Prophylactic antibiotic treatment on decompensated cirrhosis withpulmonary CT inflammatory change can effectively reduce the lung infection rate andaverage length of stay;(2) If there is the Child-pugh C level, the INR>1.5, PLT <9810^9/L or TBIL>54.4umol/L the preventive antibiotic therapy earlier can reducethe incidence of pulmonary infection during hospitalization.