重型病毒性肝炎和肝硬化患者并发自发性细菌性腹膜炎的相关性分析

Correlation analysis of serious hepatitis and hepatic cirrhosis complicated with spontaneous bacterial peritonitis

目的探讨重型病毒性肝炎和肝硬化患者并发自发性细菌性腹膜炎（SBP）的病原菌种类和，临床特点。方法对96例重型病毒性肝炎和肝硬化并发SBP患者的临床资料进行回顾性分析。结果96例患者中84例（87．5％）腹水多形核白细胞（PMN）比值≥0．50。45例腹水细菌培养阳性（46．8％），共分离细菌56株，包括7种细菌，病原菌以革兰阴性杆菌为主，大肠杆菌28株，为主要致病菌，占50％。药敏试验对第3代头孢菌素和第3代氟喹诺酮类药物敏感。结论重型病毒性肝炎和肝硬化并发SBP临床表现多数不典型，腹水PMN比值是诊断SBP的可靠指标。大肠杆菌为主要致病菌。抗感染治疗首选第3代头孢菌素和第3代氟喹诺酮类药物。

Objective To investigate the pathogen types and their clinical character of severe viral hepatitis （SH） and hepatic cirrhosis complicated with spontaneous bacterial peritonitis （SBP）. Methods The clinical datas of 96 cases SH and hepatic cirrhosis with SBP were retrospectivly analysed. Results The ratio of polymorphonuclear leukocyte （PMN） in ascites was 87. 5% （ 84/96 ）. Forty - five cases＇ bacterial cultivation were postive （46.8%） , and seperated 56 strains, including 7 types of bacteria, gram - negative bacillus were prevaining, the most important pathogen was colibacillus, which had 28 strains（50% ）. They were sensitive to the third generation cephalosporin and third generation FQNS. Conclusions The clinical situation of SH and cirrhosis complicated with SBP were atypical mostly, the ratio of PMN in ascites was a reliable index in diagnosing SBP. Colibacillus was the most important pathogen and third generation eephalosporin and third generation FQNS should be selected in anti -infection treatment.