乙型肝炎肝硬化合并自发性细菌性腹膜炎病原菌及预后危险因素  

Pathogens isolated from hepatitis B cirrhosis patients complicated with spontaneous bacterial peritonitis and risk factors for prognosis

作　　者：李欣 张晓华 朱红玉 王琳 LI Xin;ZHANG Xiao-hua;ZHU Hong-yu;WANG Lin(Qingdao Traditional Chinese Medicine Hospital(City Haici Hospital),Qingdao,Shandong 266033,China)

机构地区：[1]青岛市中医医院(市海慈医院)保健办,山东青岛266033 [2]青岛市中医医院(市海慈医院)消化科,山东青岛266033 [3]青岛市中医医院(市海慈医院)心血管二科,山东青岛266033 [4]青岛市中医医院(市海慈医院)消化一科,山东青岛266033

出　　处：《中华医院感染学杂志》2024年第13期1988-1991,共4页Chinese Journal of Nosocomiology

基　　金：山东省中医药科技发展计划基金资助项目(2019-0604)。

摘　　要：目的分析乙型肝炎肝硬化合并自发性细菌性腹膜炎(SBP)患者病原菌及预后危险因素。方法纳人2019年1月一2022年5月青岛市中医医院收治的乙型肝炎肝硬化合并SBP患者168例为研究对象,根据其1年内疾病转归情况,以死亡为预后判断终点,分别纳人转归不良组(死亡)53例、转归良好组115例,回顾性收集患者临床资料,分析乙型肝炎肝硬化合并SBP患者病原学,通过Logistic回归分析法分析乙型肝炎肝硬化合并SBP患者疾病转归危险因素。结果乙型肝炎肝硬化合并SBP患者168例,共分离病原菌189株,其中革兰阴性菌占比73.02%(以大肠埃希菌为主),革兰阳性菌占比26.98%(以表皮葡萄球菌为主)。1年内疾病转归不良53例,归转不良率为31.55%。多因素Logistic分析结果显示,腹水持续时间延长、白蛋白-胆红素评分(ALBI)评分、Child-Pugh评分、腹水中性粒细胞计数、腹水降钙素原(PCT)水平升高为乙型肝炎肝硬化合并SBP患者疾病转归不良的危险因素(P<0.05)。结论乙型肝炎肝硬化合并SBP患者病原菌以革兰阴性菌为主,疾病转归危险因素较多,可据此筛选高危患者,为预防措施的制定提供依据。OBJECTIVE To investigate the pathogens isolated from the hepatitis B cirrhosis patients complicated with spontaneous bacterial peritonitis(SBP)and analyze the risk factors for prognosis.METHODS Totally 168 hepatitis B cirrhosis patients complicated with SBP who were treated in Qingdao Traditional Chinese Medicine Hospital from Jan 2019 to May 2022 were recruited as the research subjects and were respectively assigned as the poor prognosis group(death)with 53 cases and the favorable prognosis group with 115 cases based on death as the determined end point for prognosis according to the treatment outcomes within 1 year.The clinical data were retrospectively collected from the patients,the etiological characteristics of the hepatitis B cirrhosis patients com-plicated with SBP were analyzed,and logistic regression analysis was performed for the treatment outcomes of the hepatitis B cirrhosis patients complicated with SBP.RESULTS Totally 189 strains of pathogens were isolated from the 168 hepatitis B cirrhosis patients complicated with SBP,73.02%of which were gram-negative bacteria(domi-nated by Escherichia coli),and 26.98%were gram-positive bacteria(dominated by Staphylococcus epidermidis).

关 键 词：乙型肝炎 肝硬化 自发性细菌性腹膜炎 病原菌 疾病转归 危险因素 

分 类 号：R512.62[医药卫生—内科学]