肝衰竭合并自发性细菌性腹膜炎患者肾功能改变与预后相关

Relation between renal function change and prognosis in patients with liver failure accompanying spontaneous bacterial peritonitis

目的分析肝衰竭合并自发性细菌性腹膜炎(Spontaneous Bacterial Peritonitis,SBP)患者肾功能改变与预后的关系。方法从302医院2003-2008年1 810例肝衰竭患者中选取合并SBP者143例(A组),选取腹水细胞学检查不足诊断SBP标准,但临床上应用抗生素防治感染者276例(B组)做为对照组。按出院时患者预后分好转组与非好转组。对基本资料、抗生素治疗前后肾功能变化以及患者预后等进行分析。结果两组患者出院时非好转患者肌酐值均大于好转患者(P<0.05)。A组中好转患者治疗中肌酐值明显下降(P<0.05),非好转患者肌酐值无明显变化(P>0.05)。B组非好转患者治疗5d时肌酐值升高(P=0.003)。结论肝衰竭合并SBP患者治疗过程中肌酐值下降者预后相对较好。

Objective To analyze the relation between renal function change and prognosis in patients with liver failure accompanying spontaneous bacterial peritonitis（SBP）.Methods A total of 1 810 inpatients with liver failure admitted to Chinese PLA 302 Hospital during 2003-2008 were enrolled in this study.One hundred and forty-seven patients with liver failure accompanying SBP served as group A,and 276 patients with liver failure accompanying ascites but no SBP served as group B.Their clinical data,renal function and prognosis were compared and analyzed before and after antibiotic treatment.Results The creatinine level was higher in patients with no improvement than in those with improvement when they were discharged（P0.05）.The creatinine level was lower in patients of group A with improvement than in those with no improvement（P0.05）.The creatinine level was significantly higher in patients of group B with no improvement than in those with improvement（P0.05）.Conclusion The prognosis of patients with liver failure accompanying SBP is rather good if their creatinine level is reduced after treatment.