Clinical analysis of cases of liver cirrhosis complicated with adrenal insufficiency

Objective To evaluate the baseline level of corticosteroid and adrenocorticotrophic hormone (ACTH) in patients with cirrhosis and to investigate the clinical characteristics in patients with cirrhosis complicated with adrenal insufficiency (AI) .Methods The basal level of corticosteroid and ACTH in 118 liver cirrhosis cases, who were hospitalized in the Department of Gastroenterology in our hospital were measured.Then the patients were divided into two groups as with or without AI.Clinical characteristics and prognosis of the two groups were analyzed.30 cases of gastrointestinal polypus were selected as control.Results The serum corticosteroid in 118 cirrhosis patients was (329.67±136.1) nmol/L, that was lower than that (460.7±165.48) nmol/L in the control group (t=-4.501, P<0.05) .Of 118 cases of cirrhosis, there were 32 cases combining AI and the propotion of them was 27.1% (32/118) .In addition, spontaneous bacterial peritonitis (SBP) complication rates, Child pugh grades and scores, MELD scores and fatality rates of 32 liver cirrhosis cases with AI are all higher than that in the cases without AI (P<0.05) .The level of albumin and high density lipoprotein-cholesterol was lower and the incidence rates of pigmentation, ascites and spontaneous bacterial peritonitis (SBP) are significantly higher (P<0.05) .But there was no statistically significant difference in other clinical characteristics and laboratory parameters (P>0.05) .Conclusion The level of corticosteroid and ACTH in cirrhosis patients is lower, and about 27% cirrhosis cases are complicated with AI, these patients have higher incidence rate of SBP, worse hepatic function and higher mortality, leading to poor prognosis.