The clinical significance of lactulose in cirrhosis patients with spontaneous bacterial peritonitis.

To evaluate the therapeutic effects of Lactulose in cirrhotic patients with spontaneous bacterial peritonitis (SBP). 34 SBP patients of hepatitis cirrhosis were randomized into two groups: a treating group with lactulose and a control treating group based on oral administration of lactulose or not. All cases were observed for 7days. In additiion, 11 cirrhotic patients with sterile ascitic fluid (SA) were sorted into cirrhosis SA control group. 11 healthy cases were sorted into healthy control group. The plasma levels of tumor necrosis factor-α (TNF-α), interleukine 6(IL-6) were measured with a double monoclonal sandwich enzyme linked immunosorbent assay (ELISA). The plasma levels of endotoxin(LPS) were measured with limulus amebocyte lysate test. (1)The plasma levels of TNF-α, IL-6 and LPS were significantly higher in hepatitis cirrhosis patients with SBP than those without SBP in admitting hospital (P0.05). And they were higher in cirrhosis without SBP than those in healthy control group (P0.05). (2)After being treated for one week, the plasma levels of TNF-α, IL-6 and LPS were significantly decreased in lactulose treatment group than those in standard treatment group (P0.05). (3)By Pearson correlation, in SBP patients, the plasma level of LPS had significantly correlated with the level of TNF-α and IL-6 (P0.001). Oral lactulose is beneficial to hepatitis cirrhotic patients with SBP, by reducing endotoxin and cytokines levels in plasma.