慢性重型肝炎患者并发腹膜炎后肾脏损害

Renal impairment after spontaneous bacterial peritonitis in chronic severe viral hepatitis

目的 探讨慢性重型肝炎(CSVH)并发自发性腹膜炎(SBP)后肾脏损害和肾脏损害加重(SBPRI)的临床特点、转归及影响因素。方法 对129例慢性重型肝炎并发自发性腹膜炎住院患者资料进行回顾性分析。结果 慢性重型肝病人常伴有SBPRI,患者年龄越大、病程越长、合并其他感染或糖尿病、SBP前已发生肾损害时病情越重,越易于发生SBPRI,且直接影响到病人的预后。SBP前血尿素氮(BUN)值越高、血Na+值越低、对抗生素治疗反应不良者,预后越不佳。结论 SBPRI的肾损害是功能性的,可以迅速恶化,也可以随着SBP的好转而稳定或好转。

Objective To study the clinical features、prognosis and influence factors of renal impairment (RI) in chronic severe viral hepatitis with spontaneous bacterial peritonitis (SBP).Methods 129 discharged patients with chronic severe viral hepatitis(CSVH) complicated with spontaneous bacterial peritonitis were analyzed retrospectively. Results Renal impairment is a frequent event in CSVH patients with SBP. SBP RⅠ is functional in nature, it may be followed by a rapidly progressive or a stable disease course, or may be reversed after recovery of the infection.Conclusion Independent prognostic factors were age、clinical course of liver disease, other infection or diabetes、severe renal impairment, serum sodium level before SBP and negative response to antibiotic therapy.