Multiple Indicators Diagnose The Liver Failure With Bacterial Infection

Objective: Because of the factors such as immune disorders,increasing intestinal permeability,the patients with liver failure can have a high incidence of infection,due to the high mortality rate of patients.We always use white blood cells(WBC)? C-reactive protein(CRP)and calcitonin(PCT)to monitor the infection.But these indicators in patients with liver failure can also rise,leading to the difficulties in early diagnosis of infection.The relationship between RBC and infection becomes a hotspot in recent years.The current study attempts to combine RBC and other indicators to predict the liver failure with infection early,thus reduce the mortality.Methods: A study was conducted in 176 patients with liver failure and infection who were admitted to the Tianjin second people hospital of ICU in,between January 2013 and January 2017.According to the standard and exclusion criteria,72 cases were excluded.Among 104 patients with liver failure,21 patients collected randomly were divided to validation group,the remaining 83 patients were divided into the infection and non-infection group.The hepatic biological indices,creatinine(Cr),blood coagulation,blood routine,C-reactive protein(CRP)and procalcitonin(PCT)were recorded in patients with liver failure.The patients of non-infection group were collected biological indices within 24 h when they were in hospital,and the patients of infection group were collected biological indices within 24 h when they were considered infection.Through the multivariate logistic regression analysis to build the combined forecasting model.Results: The RBC value of the liver failure infection group was 3.528 � 0.802,and the non-infected group was 4.229 � 0.798,and the P value was 0.000,and the difference was statistically significant.In the infection group the anemia patients accounted for 20.8%,and in the non-infection group the anemia patients accounted for 48.6%.The WBC ? CRP ? PCT value of the liver failure infection group was9.007�4.724,35.078�22.335,1.221�1.032,and the non-infected group was 6.435�2.048,18.209�17.907,0.640�0.467,the P value was 0.004,0.000,0.003,and the difference was statistically significant.The regression equation for the logit P =0.081 + 0.081 + 0.733(CRP)(PCT)+ 0.314(WBC)-1.090(RBC).The AUC of WBC,PCT,CRP and the Logit P was 0.691,0.724,0.739,0.862.Conclusion: We always use the WBC,CRP and PCT to predict infection,we also use them to predict the liver failure and infection.But these indicators in liver failure can also rise,thus lead to the early diagnosis of liver failure with infection difficult.Logistic regression constructed by the WBC,PCT,CRP and RBC could be used to diagnose the liver failure with bacterial infection early,and guide clinical reasonable application of antibiotics.The patients of liver failure with infection can appear the number of red blood cells low.Use the WBC,?CRP ?PCT and RBC to predict liver failure with infection,thus make reasonable application of antibiotics.