【摘要】 目的回顾性分析失代偿期肝硬化合并自发性细菌性腹膜炎(SBP)患者的易感因素及预后因素。方法研究广州市红十字会医院消化内科2015年1月-2017年12月293例住院患者中符合肝硬化腹水患者的临床资料,分析SBP组与非SBP组的易感因素及预后影响因素。结果 293例肝硬化腹水患者中发生SBP者136例,占46.4%。单因素分析显示SBP病史、白蛋白(ALB)、血Na+、总胆红素(TBIL)、降钙素原(PCT)、凝血酶原时间(PT)、肌酐(Cr)、Child-Pugh评分和并发症(上消化道出血、肝肾综合征)是诱发SBP感染的危险因素,差异有统计学意义(P<0.05);对SBP死亡组进行的预后多因素Logistic回归分析显示:上消化道出血、肝性脑病、肝肾综合征、重叠感染是导致死亡常见原因,而上消化道出血、血清ALB、血Na+、肝肾综合征是对预后有显著性影响的独立危险因素。结论SBP的发生和预后与多种因素有关,应适当处理以改善肝硬化腹水合并SBP患者的预后。更多还原

【Abstract】 Objective To investigate the multiple susceptibility and prognostic factors associated with spontaneous bacterialperitonitis(SBP)in cirrhotic ascites patients. Methods Retrospective analysis of Guangzhou Red Cross Hospital in 2015 January to 2017 December 293 cases of cirrhotic patients was performed. The univariate and multivariate analysis were usedto analyse the susceptibility and prognostic factors between the SBP groups and no-SBP groups. Results There were 136 cases of SBP in 293 cases of cirrhotic(46.4%). Univariate analysis showed that the SBP history,albumin(ALB),Na+,totalbilirubin(TBIL),procalcitonin(PCT),prothrombin time(PT),creatinine(Cr),Child-Pugh scores and complications(gastrointestinal bleeding, hepatorenal syndrome) were the risk factors for SBP.Multivariate Logistic regression analysis ofprognosis showed that upper gastrointestinal hemorrhage, hepatic encephalopathy, hepatorenal syndrome, and super-infectionwere common causes of death in the SBP death group. And upper gastrointestinal hemorrhage, ALB, Na+, hepatorenalsyndrome were independent risk factors that have significant effects on prognosis. Conclusion The incidences of SBP wasrelated to some factors,which might be properly managed in order to improve the prognosis of spontaneous bacterialperitonitis in patients with liver cirrhosis.更多还原