Abstract: Objective Microecological preparation is always applied to treat patients with liver cirrhosis complicated by spontaneous bacterial peritonitis (SBP), and we conduct a clinical trial to administer the microecological agent for the treatment of patients with SBP, and observe the changes of ascites, biochemical indexes, urinary lactulose / mannitol (L/M) ratio, serum cytokines and endotoxin. Methods 68 patients with liver cirrhosis complicated by SBP were recruited in this study between December 2014 and June 2018,and were randomly divided into control (n=34) and observation groups (n=34). The patients in the control were treated with quinolones and third generation of cephalosporins for four weeks, and the patients in the observation group were treated with microecological preparations (Peifeikang capsule) at the basis of the treatment regimen in the control group for four weeks. Urine lactulose / mannitol were detected by high performance liquid chromatography, serumprocalcitonin (PCT), IL-10, TNF-α and endotoxin levels were also determined. Results At the end of four week treatment, the abdominal circumference, 24-hour urine volume, leukocyte counts in ascites and serum PCT levels in the observation group were(67.4±10.2)cm,(1685.4±305.6)ml, (156.2±92.0)×10⁶/L and (0.45±0.15)ng/ml, all significantly different compared to 【(75.6±11.3)cm, (1450.3±326.8)ml, (360.8±110.5)×10⁶/L and (1.24±0.60)ng/ml, respectively, P<0.05】 in the control; serum ALT, AST and bilirubin levels in the observation group were (40.6±18.0)U/L,(45.8±20.4)U/L and (45.2±10.8)μmol/L, all significantly lower than 【(62.5±15.4)U/L,(59.8±21.5)U/L and (54.0±11.5)μmol/L, respectively, P<0.05】 in the control; the urine L/M ratio, serum IL-10, TNF-α and endotoxin levels were (0.07±0.01), (32.6±5.4)ng/L, (29.8±7.0)ng/L and (0.33±0.10)EU/ml, all significantly different compared to 【(0.09±0.01), (27.1±5.0)ng/L,(38.9±8.5)ng/L and (0.46±0.13)EU/ml, respectively, P<0.05】 in the control. Conclusion The application of microecological agents in assisting treatment of patients with liver cirrhosis complicated by SBP could effectively improve ascites subsidizes, protect liver functions, inhibit the expression of inflammatory cytokines, reduce intestinal endotoxin and regulate intestinal flora.

Key words: Liver cirrhosis, Spontaneous bacterial peritonitis, Microecological agents, Urinary lactulose / mannitol ratio, Endotoxin