Measurement of plasma endotoxin and procalcitonin after endoscopic treatment of esophagogastric varices in liver cirrhotic patients and the clinical significance

Abstract

Objective To study the changes of plasma endotoxin and procalcitonin in patients with esophagogastric varices and provide a theoretical basis for prophylactic antibiotics after endoscopic treatment. Methods Fifty cases of patients with esophageal and gastric varices accepted the endoscopic treatment. The patients were divided into antibiotic group (32 cases) and non-antibiotic group (18 cases). The plasma endotoxin and procalcitonin were measured before and on the first day and 7th day after endoscopic treatment. Results The plasma levels of endotoxin and procalcitonin were not significantly different on the first and 7th day after endoscopic treatment compared with preoperative levels in antibiotic group. But in non-antibiotic group, the levels significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P<0.05). And in patients of Child-Pugh A grade, the level of plasma procalcitonin significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P<0.01), but the procalcitonin was not significantly different on the first and 7th day after operation. And in patients of Child-Pugh B and C grades, the levels of plasma endotoxin and procalcitonin significantly increased on the 7th day(P<0.01). Conclusion The levels of plasma endotoxin and procalcitonin in non-antibiotic group increase after endoscopic treatment, which suggests the risk of infection. Prophylactic antibiotics after endoscopic treatment should be considered for the patients of Child-Pugh B and C grades. Key words: Esophageal and gastric varices; Endoscopes, gastrointestinal; Endotoxins; Calcitonin