Abstract: Objective The aim of this study was to evaluate the clinical value of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in predicting spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis. Methods A total of 148 patients with decompensated liver cirrhosis were included in our hospital between December 2014 and June 2018. Polymorphonuclear cells (PMN) in ascites, and serum CRP and PCT levels were detected routinely, binary Logistic regression analysis was applied to evaluate the risk factors of SBP occurrence and the diagnostic efficacy of clinical data in diagnosing SBP was analyzed by using the area under the receiver operating characteristic curve (AUROC). Results There were 90 patients diagnosed as having SBP and 58 had non-infected ascites; the Child-Pugh score in patients with SBP was (11.5±1.4), significantly higher than in patients without SBP, the PMN counts in ascites was 280.0 (61.5,582.0)×10⁶/L, significantly higher than , peripheral blood WBC count was [(7.5±3.2)×10⁹/L, much higher than [(3.8±1.7)×10⁹/L, P<0.05), serum PCT level was 3.91(1.32,9.61)ng/ml, significantly higher than and serum CRP level was (32.0±21.7) mg/L, much higher in patients without SBP; the results of Logistic regression analysis showed that PMN counts, serum PCT and CRP levels were the independent risk factors for SBP occurrence in patients with decompensated liver cirrhosis (P<0.05); the sensitivities (Se) of PMN counts in ascites, serum PCT and CRP levels in diagnosing SBP were 75.6%, 73.3% and 72.2%,and the specificities (Sp) were 68.9%, 75.6% and 88.9%, while when serum PCT equal to 0.45 ng/ml and serum CRP equal to 12.68 mg/L as the combination cut-off-value, the Se and Sp were 66.7% and 90.0%, respectively. Conclusion The measurement of PMN counts in ascites and serum PCT and CRP is helpful in diagnosing SBP in patients with decompensated liver cirrhosis in time, which might guide management of patients in this settings.

Key words: Liver cirrhosis, Spontaneous bacterial peritonitis, C-reactive protein, Procalcitonin, Receiver operating characteristic curve