肝硬化并细菌感染预后的危险因素  

Prognostic risk factors of patients with cirrhosis and bacterial infection

作　　者：赖荣昌 叶绍华[1] 莫松柳[1] Lai Rongchang;Ye Shaohua;MO Songliu(Department of Medical,Dongguan Qiaotou Hospital,Guangdong 523523,China)

机构地区：[1]广东省东莞市桥头医院内科,东莞市523523

出　　处：《中华实验和临床感染病杂志（电子版）》2018年第6期596-600,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的研究肝硬化并细菌感染者预后危险因素。方法收集2014年1月至2016年2月广东省东莞市桥头医院收治的肝硬化并细菌感染者120例。对入组患者进行为期两年的随访,根据患者生存情况将其分为死亡组(52例)和存活组(68例)。比较两组患者白细胞计数、中性粒细胞、血钠以及C-反应蛋白等实验室指标水平,以及年龄、性别、消化道出血、Child-Pugh分级、合并肺部感染、合并泌尿系感染等基本资料。应用多因素Logisitic回归分析上述各项因素与患者预后的相关性。结果死亡组患者白细胞计数、中性粒细胞、C-反应蛋白分别为(11.70±8.27)×10~9/L、(10.20±7.50)×10~9/L、(61.38±30.24)mg/L,均高于存活组患者[(8.92±6.38)×10~9/L、(7.48±5.66)×10~9/L、(48.52±20.11)mg/L],差异均有统计学意义(t=2.079、2.264、2.793,P=0.040、0.025、0.006)。死亡组患者年龄≥50岁、消化道出血、Child-Pugh分级C、合并肺部感染人数分别为42例(80.77%)、25例(48.08%)、41例(78.85%)和32例(61.54%),均高于存活组患者[33例(48.53%)、16例(23.53%)、38例(55.88%)和27例(39.71%),差异均有统计学意义(χ~2=13.068、7.894、6.908、5.620,P=0.000、0.005、0.009、0.018)。多因素Logisitic回归分析结果显示,白细胞计数、中性粒细胞、C-反应蛋白、年龄≥50岁、消化道出血、合并肺部感染、合并泌尿系感染均为肝硬化并细菌感染者死亡的独立危险因素(P均<0.05)。结论导致肝硬化并细菌感染者死亡风险的因素较多,临床工作中应综合分析,并制定出针对性的预防措施。Objective To investigate the prognostic risk factors of patients with cirrhosis and bacterial infection.Methods From January 2014 to February 2016,a total of 120 patients with liver cirrhosis and bacterial infection were collected and treated in Dongguan Qiaotou Hospital,Guangdong Province.The patients were followed up for two years and divided into death group(52 cases)and survival group(68 cases)according to their survival conditions.The white blood cell count,neutrophils,serum sodium and C-reactive protein levels,age,sex,gastrointestinal bleeding,Child-Pugh grade,pulmonary infection and urinary tract infection were compared between the two groups,respectively.Multivariate Logisitic regression analysis was used to analyze the correlation of the above factors and prognosis.Results The leukocyte count,neutrophils and C-reactive protein levels of patients in death group were(11.70±8.27)×10^9/L,(10.20±7.50)×10^9/L and(61.38±30.24)mg/L,respectively,significantly higher than those of survival group[(8.92±6.38)×10^9/L,(7.48±5.66)×10^9/L and(48.52±20.11)mg/L](t=2.079,2.264,2.793;P=0.040,0.025,0.006).In death group,there were 42 cases(80.77%)aged≥50,25 cases(48.08%)with gastrointestinal hemorrhage,41 cases(78.85%)with Child-Pugh grade C and 32 cases(61.54%)with pulmonary infection,respectively,all significantly higher than those of survival group[33 cases(48.53%),16 cases(23.53%),38 cases(55.88%)and 27 cases(39.71%),respectively(χ^2=13.068,7.894,6.908,5.620;P=0.000,0.005,0.009,0.018).Multivariate Logisitic regression analysis showed that white blood cell count,neutrophils,C-reactive protein,age≥50 years old,gastrointestinal bleeding,complicated with pulmonary infection,complicated with urinary tract infection were independent risk factors of death for patients with cirrhosis and bacterial infection(all P<0.05).Conclusions There are more risk factors for death in patients with cirrhosis and bacterial infection.Clinically,comprehensive analysis should be carried out and targeted preventive measures should b

关 键 词：肝硬化 细菌感染 预后 危险因素 多因素Logisitic回归分析 

分 类 号：R575.2[医药卫生—消化系统]