الفهرس 
Abdominal Wall Hernias
Complement Levels in Serum and Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis:Only 14 pages are availabe for public view
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Abstract
This study was carried out on 30 patients in the Department of internal medicine at AIN SHAMS University Teaching Hospital.
The patients were divided into two groups:
Group one: 15 patients of established cirrhosis with ascites had no existing evidence or past history of SBP.
Group two: 15 patients with cirrhotic ascites who are admitted with SBP or developed SBP during hospital stay diagnosed by clinical and laboratory evaluations.
Patients with hepatocellular carcinoma, hepatorenal syndrome, diabetes mellitus, portal vein thrombosis or who had received antibiotics or diuretics one week prior to admission were excluded from this study.
The aim of this study is to compare the level of ascitic fluid C3 concentration in cirrhotic patients with and without SBP monthly over a period of 3 months, to determine its possible protective role against acquiring infection.
All patients were subjected to full history taking, a thorough clinical examination, abdominal ultrasound, sonographic Doppler and routine laboratory investigationsAbout 20 ml of ascitic fluid was collected from each patient following standard aseptic technique. The ascitic fluid samples were subjected to bacteriological, cytological and routine chemical examination of ascitic fluid.
Ascitic C3 level was estimated at time of diagnosis. Over a period of 3 months, follow up paracentesis and C3 estimation in ascitic fluid was done monthly.
We observed from this study that:
The two studied groups were comparable as regards age and gender with no significant difference between them.
SBP development is influenced to a greater extent by the degree of liver disease being predominant in patients with class C (73.33%) according to Child-Pugh Classification than those patients with class B (26.67%).
Only 66.67% of patients who had or developed SBP have positive ascitic fluid culture while the remaining (33.33%) are categorized as CNNA.
The most common organisms isolated were gram negative mainly E.coli in 50% of cases, Klebsiella in 30% of cases and the remaining were gram positive organisms.
The biochemical analysis of ascitic fluid content were comparable between two studied groups with significantreduction of A.F. albumin in patients with SBP and a significant increase of A.F. neutrophilic count and LDH values in the same group.
The two studied groups were comparable at baseline regarding A.F.C3 level with more DROP of its value in patients with SBP.
Over the next 3 months, C3 levels were estimated monthly and found to be more reduced on comparing with baseline values. However, none of the two studied groups showed a significant change of A.F.C3 level over the successive 3 months.
The positive and highly significant correlation between A.F. total protein and the C3 in ascitic fluid further emphasized their role as risk factors for development of SBP in cirrhotic patients.
On the other hand, a significant negative correlation between A.F.C3 level and A.F. neutrophilic count was observed among the studied groups