肝硬化腹水患者并发自发性细菌性腹膜炎的危险因素分析  

Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascities

作　　者：陈潮文[1] 刘序友[1] 汤绍辉[1] 杨冬华[1] 劳学军[2] 

机构地区：[1]暨南大学附属第一医院消化科,广东广州510630 [2]暨南大学附属第一医院普外科,广东广州510630

出　　处：《中国现代医学杂志》2008年第11期1604-1606,1609,共4页China Journal of Modern Medicine

摘　　要：目的探讨肝硬化腹水患者并发自发性细菌性腹膜炎(SBP)的危险因素。方法将住院治疗的172例肝硬化腹水患者分为SBP组和非SBP组,从MELD评分、血清白蛋白、腹水总蛋白、是否合并肝癌、ALT、AST、年龄、性别、肝硬化病因等方面,分别采用单变量(t检验或χ2检验)及多变量(logistic回归)方法进行对比分析。结果SBP的发生率为24.4%(42/172);单变量分析显示SBP组与非SBP组之间在MELD评分、合并肝癌百分比、血清ALT和AST、血清白蛋白及腹水总蛋白6个方面差异具有显著性;logistic回归显示只有MELD评分、血清白蛋白及腹水总蛋白3个因素入选回归模型(P<0.01)。结论较高的MELD评分、较低的血清白蛋白及腹水总蛋白浓度3者可能是肝硬化腹水患者并发SBP的独立高危因素。[Objective] To investigate the risk factors for spontaneous bacterial peritonitis （SBP） in cirrhotic patients with ascities. [Methods] 172 cirrhotic patients with ascities, which were divided into two groups, the one with SBP and the other without SBP, were included in this study. The following factors such as model for end-stage liver disease （MELD） score, serum albumin, ascitic fluid total protein, complication with and without hepatocellular carci- noma, serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST）, sex, age, and cause of cirrhosis were analyzed. [Results] ①Prevalence of SBP was 24.4% （42/172）. @）Univariate analysis revealed significant differences between the groups with and without SBP with regard to MELD score, serum albumin, ascitic fluid total protein, complication with and without hepatocellular carcinoma, serum ALT and AST.②On logistic regression analysis, MELD score, serum albumin level, and ascitic fluid total protein level were selected as significant independent factors contributing to the development of SBP （P 〈0.01）. [Conclusion] The high MELD score, low serum albumin and ascitic fluid total protein levels were independently associated with a greater risk of SBP.

关 键 词：肝硬化 自发性细菌性腹膜炎 危险因素 

分 类 号：R575.2[医药卫生—消化系统]