Objective      To study the clinical features of chronic severe viral hepatitis B patients complicated with spontaneous bacterial peritonitis (SBP) to improve the therapeutic effect and prognosis.     Methods      A total of 400 inpatients with chronic severe viral hepatitis B in our department from Jan. 2008 to Dec. 2010 were enrolled. Retrospective data from the clinical records of 163 consecutive episodes of SBP were selected

including 137 men and 26 women with an average age of 44.21±11.30. Clinical manifestations

blood routine

ascites routine and bacterial culture of the patients were examined. The patients were treated with antibiotics based on the drug sensitivity test and clinical experience. The therapeutic effect and prognosis were further evaluated.      Results      The main clinical manifestations of the 163 patients comprised abdominal tenderness (75.46%)

abdominal distension (61.35%)

abdominal ache (52.15%) and rebound tenderness (47.24%). The main complications were hepatic encephalopathy (30.06%)

and renal dysfunction (19.63%). The uncommon clinical manifestations were gastrointestinal hemorrhage

shock and fever. The ascending rates of white blood cell count and neutrophilic granulocyte ratio in ascites were 17.79% (29/163) and 16.56% (27/163)

respectively. The positive rates of bacterial culture in ascites and in peripheral blood were 2.35% and 23.53%

respectively. Almost all the bacteria were Gram-negative bacillus. The death rate of chronic severe viral hepatitis B complicated with SBP was 4.29% during hospital. Except for automatic discharge

the death rate was up to 15.56% and the curative rate was 84.44%. Age

liver encephalopathy

abnormal renal function

total bilirubin and prothrombin time (P0.05) are significance in two groups.    Conclusion      Chronic severe viral hepatitis B patients complicated with (SBP).  Early diagnosis and timely and experiential anti-infection treatment could improve the therapeutic effect.