【摘要】 目的探讨乙型肝炎肝硬化腹水患者并发自发性细菌性腹膜炎(SBP)的危险因素。方法将218例乙型肝炎肝硬化腹水患者按有无SBP分为SBP组(128例)和非SBP组(90例)。对2组年龄、性别、血清白蛋白(ALB)、总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、凝血酶原活动度(PTA)、Child-Pugh分级、腹水总蛋白和是否合并糖尿病、上消化道出血等因素进行单因素及多因素Logistic回归分析。结果单因素分析示:SBP组血清TBIL高于非SBP组,血清ALB、PTA及腹水总蛋白低于非SBP组(均P<0.05);SBP组Child-Pugh C级、合并糖尿病及上消化道出血的比例分别为77.34%、12.50%及9.38%,非SBP组Child-Pugh C级、合并糖尿病及上消化道出血的比例分别为48.89%、3.33%及2.22%,SBP组均明显高于非SBP组(均P<0.05)。多因素Logistic回归分析示:血清TBIL、ChildPugh分级及腹水总蛋白进入回归模型,这3项指标是乙型肝炎肝硬化腹水患者发生SBP的独立危险因素(P<0.01)。结论乙型肝炎肝硬化腹水患者并发SBP的危险因素众多,其中血清TBIL、Child-Push分级、腹水总蛋白是发生SBP的独立危险因素。更多还原

【Abstract】 Objective To study the risk factors for spontaneous bacterial peritonitis(SBP)in patients with hepatitis B virus-related cirrhosis and ascites. Methods A total of 218 patients with hepatitis B virus-related cirrhosis and ascites were randomly divided into SBP group(n=128) and nonSBP group(n =90).The age,gender,serum albumin(ALB),total bilirubin(TBIL),alanine aminotrans-ferase(ALT),aspertate aminotransferase(AST),prothrombin activity(PTA),Child-Pugh grade, ascites total protein, diabetes mellitus, upper gastrointestinal bleeding and other factors were analyzed using single factor analysis and multi-factor logistic regression analysis. Results Single factor analysis showed that SBP group had higher levels of TBIL but lower levels of ALB, PTA and ascites total protein than non-SBP group(all P <0.05). Furthermore, incidences of Child-Pugh C, diabetes mellitus and upper gastrointestinal bleeding in SBP group were significantly higher than those in non-SBP group(77.34%, 12.50% and 9.38% vs 48.89%, 3.33% and 2.22%, respectively; all P <0.05). Multi-factor logistic regression analysis showed that serum TBIL, Child-Pugh grade and ascites total protein were the independent risk factors for SBP in patients with hepatitis B virus-related cirrhosis and ascites(P< 0.01). Conclusion Patients with hepatitis B virus-related cirrhosis and ascites have multiple riskfactors for SBP. However, serum TBIL, Child-Pugh grade and ascites total protein were the independent risk factors for SBP.更多还原