الفهرس 
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Abstract
Abstract:
Purpose: Spontaneous bacterial peritonitis (SBP) is the most frequent infection in patients with cirrhosis causing significant mortality which requires rapid recognition for effective antibiotic therapy, whereasascitic fluid cultures are frequently negative. The aim of this study was toevaluate efficacy of macrophage inflammatoryprotein-1 beta (MIP-1β) measured in ascitic fluid fordiagnosis of SBP and toassess the usefulness of macrophage inflammatoryprotein-1 beta (MIP-1β) in ascitic fluid as a prognosticmarker after antibiotic therapy in SBP.
Material/methods: Fifty patients with chronic liver disease and ascites were included into this study and were divided into two groups. group 1 (25 patients): SBP patients proved on clinical signs and cell count (>250 cells/mm3) and group 2 (25 patients): control group patients with ascites but no SPB. Ascitic MIP-1β was measured in both group then measured in group 1 after 3 days of antibiotic therapy.
Results: MIP-1b in theascitic fluid was significantly higher in patients with SBP (Mean = 348pg/ml vs. Mean = 47pg/ml in patients without SBP). The sensitivity and specificity for diagnosis of SBP with ascitic MIP-1b were 96% and 88%,respectively (cut-off value 59pg/ml) with AUROC 0.987 . The mean level of MIP-1β in cases group before antibiotic therapy was 384.28 pg/ml while after antibiotic therapy, it was 176.76 pg/ml with a highly significant statistical difference (P value > 0.001).
Conclusions: MIP-1β concentration in ascitic fluid may distinguish patients with and without SBP and may play a prognostic role in follow up of cases of SBP after antibiotic therapy.