The Clinical Research Of Seurm Von Willebrand Factor In Cirrhotic Patients With Spontaneous Bacterial Peritonitis

Objective:To explore the clinical value of VWF(von willebrand factor)in cirrhotic patients by comparing the serum plasma VWF levels in hepatitis b cirrhotic patients with and without SBP(spontaneous bacterial peritonitis),before and after treatment in hepatitis b cirrhotic patients with SBP.Method:1.The clinical data of the patients,who were diagnosed with hepatitis b cirrhosis,was collected from July 2015 to December 2016 in the department of infection disease of The Second Affiliated Hospital of Chongqing Medical University.Their examinations including hepatic function,prothrombin time,blood routine examination,procalcitionin,renal function and abdominal utrasonography,were examining in 48 hours.A part of patients have the examination about ascites.A total of 204 patients were selected,but some of them were excluded according to the other factor which was associated with von willebrand factor or liver function.Clinical manifestation or laboratory examination warned heptic failure,other infection with the exception of SBP,having used antibiotic before being hospitalized,SBP was not under control after two-week's antibiotics treatment,cardiovascular system diseases,diabetes,hyperlipidemia,tumor,the hemorrhagic disease and having used antiplatelet or anticoagulant drugs in two weeks.A total of 92 patients,including 61 male and 31 female,were enrolled in the study.All of them have signed the informed consent.The data includes age,gender,albumin,total bilirubin,and prothrombin time,ascites qualitative and quantitative,hepatic encephalopathy,ascites routing analysis,ascites culture and the serum level of von willebrand factor.2.Statistical analysis was going on after data collected.There are three groups according to whether having ascites,whether having SBP in the patients with ascites,The VWF level was compared between each two groups by using analysis of variance.The von willebrand factor was also compared between the before treatment and after treatment in the cirrhotic patients with SBP by using comparative t-test.Results:1.The plasma VWF level was significantly higher in the patients with SBP(2741.18�651.35)than that in the patients only with ascites,without SBP(2022.70�527.41).The difference was statistically significant(P<0.001).The plasma VWF level was significantly higher in the patients only with ascites(2022.70�527.41),without SBP,than that in the patients without ascites(1462.41 � 323.62).The difference was statistically significant(P=0.004).2.The plasma VWF level in the hepatitis b cirrhotic patients with SBP and ascites was reduced from 2741.18�651.35 to 2197.52�562.70 after using effective antibiotics in two weeks.The difference was statistically significant(P<0.001).Conclusion:In the hepatitis b cirrhotic patients,the plasma VWF was significantly higher in these with SBP than those without SBP.The plasma VWF level in these with SBP and ascites was reduced after efficient treatment.The plasma VWF level has a certain diagnostic value to distinguish the cirrhotic patients with ascites whether being with SBP.It also become a potential treatment target.