الفهرس 
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Abstract
LERS and MPO can serve as a sensitive and specific test for diagnosis of SBP. The aim of the present work is to assess the role of Leukocyte Esterase Reagent Strips (LERS) and ascitic fluid Myeloperoxidase (MPO) for diagnosis of spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis.
This study was conducted on ninety patients with decompensated chronic liver disease and ascites admitted to Tropical Medicine Department, Menoufia university hospital from January 2021 to October 2021. Patients enrolled in this study were divided into three groups: group I (no. = 20): Included cirrhotic patients with sterile ascites (no symptoms and PMN count < 250 cells/mm³). group II (no. = 35): Included symptomatic patients (picture of SBP) with PMN count < 250 cells/mm³ and group III (no. = 35): Included symptomatic patients (picture of SBP) with PMN count > 250 cells/mm³.
Patients were 58 (64.44%) males and 32 (35.55%) females. Their ages were ranged from 44 to 75 years old.
All participants were subjected to the following:
Complete history taking, complete clinical examinations and full investigations including: Complete blood count, liver function tests, serological tests for viral hepatitis markers as HBsAg and HCV Ab, serum alphafetoprotein, ESR, kidney function tests, electrolytes as Na and K, abdominal ultrasonography and ascetic fluid sample analysis for PMNs count, MPO level and LERS.
Data were statistically analyzed using SPSS (statistical package for social science/IBM, Chicago, USA) program version 13 for windows. P-value <0.05 considered statistically significant.
Statistical analysis of the presenting data revealed:
No significant difference between the studied groups as regards age, sex distribution, special habits and cause of hospitalization.
The main presentations among studied groups were diarrhea, fever, abdominal pain, anorexia, dysentery, vomiting, dyspepsia, jaundice, tenesmus, dyspnea, melena, hematemesis, constipation, hiccough, dysphagia, eructation and heart burn with highly significant difference between groups as regards fever and abdominal pain, and significant difference between them as regards diarrhea.
There was a statistical highly significant difference between studied groups as regards jaundice, pulse, temperature and tender abdomen.
According to liver profile there was statistical significant difference between studied groups as regards (ALT and international normalized ratio).
Renal functions tests of patients revealed there was statistical highly significant difference between studied groups as regards blood urea.
There was a statistical highly significant difference between studied groups as regards CRP, ESR, TLC and ascitic PMNs.
As regards ascitic MPO level and LERS, there was statistical highly significant difference between groups, where MPO and LERS were significantly higher in group Ⅲ when compared to groups’ Ⅰ and Ⅱ.
Summary
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Abdominal ultrasound revealed statistical highly significant difference between studied groups as regards ascites turbidity.
There was statistically significant positive correlation between MPO and LERS vs ascetic PMNs, ESR, TLC and CRP.
The validity of MPO in diagnosis of SBP at cut off value (> 959.7 ng/mL) had sensitivity, specificity, PPV, and NPV 100%. While the validity of LERS in diagnosis of SBP at cut off value (>15 leukocytes/μl) had sensitivity, specificity, PPV, and NPV 100%, 60%, 61%, and 100% respectively with total accuracy 76%.