慢性乙型重型肝炎继发性感染的临床特点

Clinical behavior of secondary bacterial infection in patients with chronic fulminant hepatitis B

目的研究慢性乙型重型肝炎继发性感染的临床特点。方法回顾性分析南方医科大学南方医院感染病内科收治的68例慢性乙型重型肝炎继发性感染的临床特点。结果68例病人中发生继发感染者61例(76.5%),其中33例出现2个以上部位感染。较常见的感染部位为腹腔、肺部和胆道,感染率分别为45.5%、38.2%和33.8%;其他感染部位有泌尿道、口腔、上呼吸道、肠道、败血症,感染率分别为7.4%、5.8%、4.4%、2.9%和2.9%。真菌感染20例,占所有感染的29.4%。继发感染病人体温可表现为高热、低热或体温正常;外周血白细胞和中性粒细胞比率可增高或正常。结论慢性乙型重型肝炎病人发生继发性感染比率高,表现复杂。

Objective To study the clinical behavior of secondary bacterial infection in patients with chronic fulminant hepatitis B. Methods The clinical data of 68 cases of chronic fulminant hepatitis B with secondary bacterial infection were analyzed retrospectively. Results 61cases （76. 5%） developed bacterial infection in total of 68 cases with chronic fulminant hepatitis B and 33 cases developed bacterial infection in more than 2 sites. The common infection sites were abdominal cavity,lung and biliary tract with infection rates of 45. 5% ,38. 2% and 33. 8% ,respectively. The other infection sites were urinary tract,buccal cavity, upper respiratory tract, intestines and septicemia with infection rates of 7. 4%, 5. 8%, 4. 4% ,2. 9% and 2. 9%, respectively. 20 cases （29. 4%） developed fungal infection. Hyperpyrexia, low fever or normal body temperature with high or normal of white blood cell counts and neutrophil cells in peripheral blood were present in the patients with secondary bacterial infection. Conclusion Secondary bacterial infection is present highly in patients with chronic fulminant hepatitis B.