自发性细菌性腹膜炎的预后分析  

Prognostic analysis of spontaneous bacterial peritonitis

作　　者：周小兵[1] 刘艳民[1] 刘慧敏[2] 谷莉莉[2] 曾辉[1] 王宪波[1] 

机构地区：[1]首都医科大学附属北京地坛医院,北京100015 [2]北京中医药大学

出　　处：《中华实验和临床感染病杂志（电子版）》2013年第5期9-12,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：北京市卫生系统高层次人才专项(2013-2-11);北京市科技计划课题(No.Z111107056811044);北京市中医药科技发展基金科技提升专项(No.KJTS2011-05)

摘　　要：目的探讨影响肝硬化合并自发性细菌性腹膜炎(SBP)预后的独立指标并建立危险指数模型。方法回顾性分析133例SBP患者,根据死亡与否分为死亡组和生存组,用单变量(t检验)和多变量(Logistic回归)方法对两组患者的临床资料进行比较分析并建立危险指数模型。结果影响自发性细菌性腹膜炎短期预后的指标有:腹水葡萄糖、氯、尿素、肝性脑病,根据以上指标建立危险指数模型:PI=9.512-0.303×腹水葡萄糖-0.104×氯+0.108×尿素+0.709×肝性脑病。界值为:-0.78。受试者工作特征(ROC)曲线下面积为0.846。结论本研究建立的危险指数模型对判断自发性细菌性腹膜炎的近期预后准确性高,为临床病情评估,合理用药,改善预后提高参考。Objective A risk index model was established by the statistical analysis of the risk factors which affect the prognosis of patients with SBP. Methods Total of 133 patients with SBP were included in the retrospective investigation and were divided into two groups： survival group and death group. Then, the univariate and multivariate analysis were performed to analyse the differences between the groups and a risk index model was established. Results Logistic regression analysis showed that the independent factors affecting the prognosis of patients with SBP were glucose of ascite（AG）, Cl, urea and hepatic encephalopathy. According to the above factors, the risk index model was established as follows： PI =9.512 - 0.303 × AG - 0.104 × Cl ＋ 0.108 × UREA ＋ 0.709 × HE. The cut-off vale was -0.78. The area under the receiver operating characteristic curve （AUROC） was 0.846. Conclusions The risk index model established in this study has a high accuracy in judging the prognosis of patients with SBP, which provides reference for condition assessment and use of drugs.

关 键 词：肝硬化 自发性细菌性腹膜炎 预后分析 LOGISTIC回归模型 

分 类 号：R575.2[医药卫生—消化系统]