肝硬化腹水并发自发性细菌性腹膜炎的临床特征及危险因素分析  

Clinical characteristics of cirrhosis ascetic complicated with spontaneous bacterial peritonitis and its related risk factors

作　　者：胡利萍[1] 依巴古力.艾拜都拉 努力比亚.阿不都克尤木 伊法热.买买提艾力 买买提艾力.吾布力 张跃新[1] 

机构地区：[1]新疆医科大学第一附属医院感染科,新疆乌鲁木齐830054

出　　处：《实用临床医药杂志》2015年第11期29-31,共3页Journal of Clinical Medicine in Practice

基　　金：新疆维吾尔自治区自然科学资助项目(2015211C048)

摘　　要：目的探讨肝硬化腹水并发自发性细菌性腹膜炎(SBP)的临床特征及危险因素。方法回顾性分析85例肝硬化腹水并发SBP患者的临床资料,总结其临床表现、实验室检查特征及治疗转归情况,并对所有临床病理因素进行Logistic回归分析。结果本组患者主要临床表现为发热、腹胀和腹痛;血常规及腹水中的白细胞计数(WBC)均显著升高,中性粒细胞(PMN)比值>0.5者达83.53%;53例患者腹水细菌培养阳性(62.35%),4例真菌培养阳性(4.71%)。至2014年8月,35例(41.18%)SBP治愈或好转,50例(58.82%)无效或恶化。Logistic多元回归分析表明,腹水蛋白及消化道出血是肝硬化腹水并发SBP的独立影响因素。结论肝硬化腹水并发SBP主要临床表现为发热、腹胀和腹痛,血常规及腹水中的WBC均显著升高,治疗转归较差,腹水蛋白及消化道出血是其发病的独立危险因素。Objective To investigate the clinical characteristics of cirrhosis ascetic complicated with spontaneous bacterial peritonitis（ SBP） and its related risk factors. Methods The clinical data including medical diagnosis,laboratory outcomes and prognosis of 85 cirrhosis ascetic patients complicated with SBP were retrospectively analyzed. All clinical factors were included for Logistic regression analysis. Results Fever,abdominal distension and abdominal pain were main symptoms observed in patients. Blood routine and white blood count（ WBC） in ascites was increased and the proportion of patients with ratio of polymorphonuclear neutrophils（ PMN） was83. 83%. Fifty three（ 62. 35%） patients with positive of ascites bacteria culture and 4 patients（ 4.71%） with positive of fungal culture. 35 patients（ 41. 18%） were cured or improvement and 50 patients（ 58. 82%） were inefficacy or deterioration. Logistic analysis showed the ascites fluid total protein and gastrointestinal hemorrhage were independently associated with SBP. Conclusion Clinical symptoms of cirrhosis ascetic complicated with SBP mainly include fever,abdominal distension and pain,and increased blood routine and WBC in ascites. Ascites fluid total protein and gastrointestinal hemorrhage are two independent risk factors to SPB.

关 键 词：肝硬化 腹水 自发性细菌性腹膜炎 白细胞计数 细菌培养 

分 类 号：R572.2[医药卫生—消化系统]