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 ...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.展开更多
文摘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.