Abstract： Objective To explore the influencing factors of spontaneous bacterial peritonitis and the predictive value of mul-tiple inflammatory indicators in elderly alcoholic liver cirrhosis patients.Methods A total of 276 patients with alcoholic cirrhosis hos-pitalized in Beijing Friendship Hospital,Capital Medical University from January 2020 to June 2023 were selected for retrospective a-nalysis.Seventy-two elderly patients with alcoholic cirrhosis who had spontaneous bacterial peritonitis at admission were included in the observation group,and 204 elderly patients with alcoholic cirrhosis who did not have SBP were included in the control group.The clini-cal data of patients in the two groups were collected by an electronic medical record system at admission.Multivariate logistic regression model was used to analyze the correlation between inflammatory factors and spontaneous bacterial peritonitis.ROC curve was used to e-valuate the diagnostic efficacy of inflammatory factors for spontaneous bacterial peritonitis.Results Univariate analysis showed that the proportion of combined diabetes,hepatic encephalopathy,and upper gastrointestinal bleeding in the observation group was higher than that in the control group,prothrombin time was longer than that in the control group,neutrolphil to lymphocyte ratio(NLR)and C-reactive protein to albumin ratio(CAR)were higher than those in the control group,and lymphocyte to monocyte ratio(LMR)was lower than that in the control group,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression model showed that upper gastrointestinal bleeding,NLR and CAR were independent risk factors for spontaneous bacterial peritonitis in elderly patients with liver cirrhosis(P<0.05),and LMR was a protective factor(P<0.05).ROC curves showed that NLR had the highest efficacy in diagnosing spontaneous bacterial peritonitis in ALC patients,CAR was intermediate,and LMR was the lowest.Conclusion Upper gastrointestinal bleeding,NLR,LMR and CAR are the influencing factors of spontaneous bacterial perito-nitis in elderly patients with alcoholic cirrhosis.NLR,LMR and CAR have certain diagnostic value for spontaneous bacterial peritoni-tis,and NLR has the highest diagnostic efficacy.