肝硬化自发性细菌性腹膜炎预后相关因素分析  

Analysis of prognostic factors for spontaneous bacterial peritonitis in cirrhotic patients

作　　者：吴梓苗[1,2] 盛吉芳[2] 相代荣[1] 

机构地区：[1]浙江大学医学院附属第一医院传染科,浙江杭州310003 [2]慈溪市人民医院感染科,浙江慈溪315300

出　　处：《中国微生态学杂志》2010年第4期342-345,共4页Chinese Journal of Microecology

摘　　要：目的探讨影响肝硬化自发性细菌性腹膜炎(SBP)患者预后的相关因素。方法将130列肝硬化SBP患者分为治愈好转组和无效死亡组,分析比较2组患者临床资料,并对有意义的单因素进一步行Logistic回归分析。结果单因素分析显示SBP病史、上消化道出血、肝性脑病、肝肾综合征、休克血压、重度低钠血症、高胆红素血症和脉博>100次/min8个因素在2组间的差异有显著性(P均<0.05);而年龄、性别、肝硬化原因、血清白蛋白、腹水总蛋白、腹水白细胞、凝血酶原时间和是否合并糖尿病等因素的差异无显著性(P均>0.05)。Logistic回归分析表明:SBP病史、肝肾综合征、休克血压和脉博>100次/min是影响肝硬化SBP预后的独立危险因素。结论SBP病史、肝肾综合征、休克血压和脉博>100次/min4个因素可能是影响肝硬化SBP预后的独立高危因素,对于具有这些高危因素的患者在临床中应加以重视。Objective To investigate the prognostic factors for spontaneous bacterial peritonitis（SBP） in cirrhotic patients. Method 130 spontaneous bacterial peritonitis in cirrhotic patients were enrolled and divided into Improved group or Deteriorated group. The clinical data were analyzed by using chi-square test and Binary logistic regression. Result Univariate analysis identified significant differences between the two groups with regard to SBP history,upper gastrointestinal hemorrhage,hepatic encephalopathy,hepato-renal syndrome,lower blood pressure,serious hyponatremia,hyperbilirubinemia and pulse100. There were no statistical differences in age,gender,cause of cirrhosis,serum albumin,ascetic fluid total protein,ascetic fluid leukocyte number,prothromtin time （PT） and diabetes between the two groups. On the logistic regression analysis,SBP history,hepato-renal syndrome,lower blood pressure and pulse〉100 were selected as significant independent factors of prognosis.Conclusion SBP history,hepato-renal syndrome,lower blood pressure and pulse〉100 are significant independent factors of prognosis and may be useful to guide clinical treatment.

关 键 词：肝硬化 自发性细菌性腹膜炎 预后 LOGISTIC模型 

分 类 号：R657.31[医药卫生—外科学]