摘要
AIM: To investigate the early diagnostic methods of bacterial and fungal infection in patients with chronic cholestatic hepatitis B.METHODS: One hundred and one adult in-patients with chronic hepatitis B were studied and divided into 3 groups:direct bilirubin (DBil)/total bilirubin (TBil)≥0.5, without bacterial and fungal infection (group A, n=-38); DBil/TBil<0.5, without bacterial and fungal infection (group B, n=23),DBil/TBil≥0.5, with bacterial or fungal infection (group C,rr=-40). The serum biochemical index and pulse rate were analyzed.RESULTS: Level of TBil, DBil, alkaline phosphatase (ALP) and DBiI/ALP in group A increased compared with that in group B. The level of ALP in group C decreased compared with that in group A, whereas the level of TBil, DBil and DBiI/ALP increased (ALP: 156+43, 199+68, respectively,P<0.05, TBil: 370+227, 220+206, respectively, P<0.01,DBil: 214+143, 146+136, respectively, P<0.01, DBiI/ALP:1.65+1.05, 0.78+0.70, respectively, P<0.001). The level of DBil and infection affected DBiI/ALP. Independent of theeffect of DBil, infection caused DBiI/ALP to rise (P<0.05).The pulse rate in group A decreased compared with that in group B (63.7+6.4, 77.7+11.4, respectively, P<0.001),and the pulse rate in group C increased compared withthat in group A (81.2+12.2, 63.7+6.4, respectively, P<0.001).The equation (infection=0.218 pusle rate +1.064 DBiI/ALP-16.361), with total accuracy of 85.5%, was obtained from stepwise logistic regression. Pulse rate (≥80/min) andDBiI/ALP (≥1.0) were used to screen infection. The sensitivity was 62.5% and 64.7% respectively, and the specificity was 100% and 82.8% respectively.CONCLUSION: Bacterial and fungal infection deterioratejaundice and increase pulse rate, decrease serum ALP andincrease DBiI/ALP. Pulse rate, DBiI/ALP and the equation(infection=0.218 pusle rate+1.064 DBil/ALP-16.361) arehelpful to early diagnosis of bacterial and fungal infectionin patients with chronic cholestatic hepatitis B.
AIM:To investigate the early diagnostic methods of bacterial and fungal infection in patients with chronic cholestatic hepatitis B. METHODS:One hundred and one adult in-patients with chronic hepatitis B were studied and divided into 3 groups: direct bilirubin(DBil)/total bilirubin(TBil)≥0.5,without bacterial and fungal infection(group A,n=38);DBil/TBil <0.5,without bacterial and fungal infection(group B,n=23); DBil/TBil≥0.5,with bacterial or fungal infection(group C, n=40).The serum biochemical index and pulse rate were analyzed. RESULTS:Level of TBil,DBil,alkaline phosphatase(ALP) and DBil/ALP in group A increased compared with that in group B.The level of ALP in group C decreased compared with that in group A,whereas the level of TBil,DBil and DBil/ALP increased(ALP:156±43,199±68,respectively, P<0.05;TBil:370±227,220±206,respectively,P<0.01; DBil:214±143,146±136,respectively,P<O.01;DBil/ALP: 1.65±1.05,0.78±0.70,respectively,P<O.001).The level of DBil and infection affected DBil/ALP.Independent of the effect of DBil,infection caused DBil/ALP to rise(P<0.05). The pulse rate in group A decreased compared with that in group B(63.7±6.4,77.7±11.4,respectively,P<O.001), and the pulse rate in group C increased compared with that in group A(81.2±12.2,63.7±6.4,respectively,P<0.001). The equation(infection=0.218 pusle rate+1.064 DBil/ALP -16.361),with total accuracy of 85.5%,was obtained from stepwise logistic regression.Pulse rate(≥80/min)and DBil/ALP(≥1.0)were used to screen infectión.The sensitivity was 62.5% and 64.7% respectively,and the specificity was 100% and 82.8% respectively. CONCLUSION:Bacterial and fungal infection deteriorate jaundice and increase pulse rate,decrease serum ALP and increase DBil/ALP.Pulse rate,DBil/ALP and the equation (infection=0.218 pusle rate+l.064 DBil/ALP-16.361)are helpful to early diagnosis of bacterial and fungal infection in patients with chronic cholestatic hepatitis B.
