Acta Medica Medianae (Apr 2008)
IMPORTANCE OF ACUTE PHASE INFLAMMATION SERUM LEVEL MARKERS FOR EARLY DETECTION, FOLOW-UP AND INITIAL PROGNOSIS OF BACTERIAL LOW RESPIRATORY TRACT INFECTIONS IN PATIENTS WITH ALCOHOL LIVER CIRRHOSIS
Abstract
Combined metabolic and haemodynamic changes in patients (pts) with alcohol liver cirrhosis induce a significant loss of immune response, which represents the main cause of bacterial infections, primarily of low respiratory tract, with high risk of mortality.Considering the influence of bacterial low respiratory tract infections on the course and prognosis of liver cirrhosis, comparing the level of general inflammation response, the clinical data of 67 alcohol liver cirrhosis pts in Child B stage of disease were retrospectively analyzed, diagnosed and treated from September 2001 till February 2006. Regarding the presence of infection, pts were divided in two groups: I-experimental including 37 pts and II-control group with 30 pts.In I group of pts, a significant initial increase of C-reactive protein and fibrinogen serum level (p<0.001) were reported as well as increased erythrocyte sedimentation rate (p<0.05) compared to the control group. The same values were significantly decreased after antibiotic treatment. Gram-negative bacteria were dominant in the culture isolates, the total proteins and albumins serum levels were initially significantly lower (p<0.05), while alanin-aminotranspherasis and lactate dehydrogenase were increased (p<0.05) compared to the control group, with further normalizing tendency at the end of antibiotic treatment.Early detection of bacterial low respiratory tract infections in patients with alcohol liver cirrhosis, by determination of acute phase inflammation serum level markers, is important in achieving the effective and prolonged remission of disease, but it still remains the missing link in complex chains of the unfavorable disease course activation.
