乙肝相关慢加急性肝功能衰竭患者并发肺部感染的临床研究  

Clinical study of hepatitis B virus-related acute-on-chronic liver failure patients complicated with pulmonary infection

作　　者：石磊[1] 徐斌[1] 于法涛[1] 谢智慧[1] 冯玉岭[1] 

机构地区：[1]淄博市中心医院感染性疾病科,山东淄博255036

出　　处：《中华医院感染学杂志》2016年第21期4900-4902,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金项目(ZR2015HQ023)

摘　　要：目的分析血乙肝相关慢加急性肝功能衰竭(HBV-ACLF)患者中的肺部感染状况,为临床应用提供参考依据。方法选取2012年1月-2015年12月医院收治266例HBV-ACLF患者为研究对象,分析病原菌分布状况、各年的感染率变化、临床资料和血清指标。结果 266例患者中合并肺部感染59例,感染率为22.2%,有14例患者检出15株病原菌,其中真菌感染最多;各年的肺部感染率比较,差异无统计学意义;年龄≥50岁、合并肝硬化、糖尿病、自发性细菌性腹膜炎(SBP)、肝性脑病(HE)、消化道出血和肝肾综合征(HBS)等感染率显著升高,差异有统计学意义(P<0.05)。结论肺部感染是HBV-ACLF的常见并发症,真菌是最常见的病原菌,年龄、合并糖尿病、合并SBP、ALB等多种因素可能与其发生有关。OBJECTIVE To investigate the prevalence of pulmonary infection in patients with hepatitis B virus-relat- ed acute-on-chronic liver failure （HBV-ACLF） so as to provide guidance for clinical application. METHODS A total of 266 patients with HBV-ACLF who were treated in the hospital from Jan 2012 to Dec 2015 were recruited as the study objects. The distribution of pathogens, change of infection rate, clinical data, and serum indexes were ob- served. RESULTS Of the 266 patients, 59 were complicated with pulmonary infection, with the infection rate 22.2~; totally 15 strains of pathogens were isolated from 14 patients, among which the fungi were dominant. There was no significant difference in the incidence of pulmonary infection. The infection rate was significantly in- creased in the patients with no less than 50 years of age, complication of liver cirrhosis, diabetic mellitus, sponta- neous bacterial peritonitis （SBP）, hepatic encephalopathy （HE）, gastrointestinal hemorrhage, and hepatorenal syndrome （P〈 0. 05）. CONCLUSION The pulmonary infection is a common complication in the patients with HBV-ACLF. The fungi are dominant among the pathogens. The incidence of pulmonary infection may be associat- ed with the age, complication of diabetic mellitus, complication of SBP, and ALB.

关 键 词：肺部感染 肝功能衰竭 肝炎病毒 乙型 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]