小肠细菌过度生长与肝硬化并发自发性腹膜炎

Small Intestinal Bacterial Overgrowth and Liver Cirrhosis Intercurrent Spontaneous Bacterial Peritonitis

目的探讨小肠细菌过度生长(SIBO)与肝硬化并发自发性腹膜炎(SBP)之间的关系,方法对80例肝硬化患者的SIDO和并发SBP情况进行分析,并与健康对照组进行比较。结果 80例肝硬化患者中27例SIBO阳性,阳性率33.75%(27/80),按Child-Pugh分级分组,分为A级、B级、C级三组,其SIBO阳性率分别为14.8%(4/27)、29.6%(8/27)、57.7%(15/26),各组间比较差异有显著性(P<0.01)。健康对照组25例SIBO全为阴性,与肝硬化组比较差异有显著性(P<0.01)。58例肝硬化并发SBP患者中有25例SIBO阳性,阳性率为43.1%;22例未并发SBP患者2例存在SIBO阳性,阳性率为9.1%,两组比较有统计学差异(P<0.01)。肝硬化并发SBP且SIBO阳性的25例患者,经2周治疗后有20例SIBO转阴,其中并发SBP的有2例,而在治疗后SIBO仍然阳性的5例患者中,并发SBP者有4例。结论肝硬化患者SIBO发生率高,并且随着肝功能损害程度的加重,SIBO发生率也随之增加,肝硬化伴SBP者SIBO发生率增加尤为显著。治疗SIBO能显著减少SBP的发生率。

Objective To investigate the relationship betwean the Small intestinal bacterial overgrowth（SIBO）and liver cirrhosis intercurrent spontaneous bacterial pertitonitis（SBP）. Methods To 80 cases of liver cirrhosis, the condition of SIBO and SBP, comparisons and analyses were carried on them separately. Results In 80 cases of liver cirrhosis,27 patients with SI- BO and the positive rate was 33.75% （27/80）. According to the Child-Pugh classification,80 cases dvided into Grade A,Grade B and Grade C three groups, its positive rate of SIBO respectively was 14.8 % （4/27） ,29.6% （8/27） , 57.7 % （ 15/26 ）, differ- ence between the three groups was statistically significant（ P 〈 0.01 ）. 25 cases in the control group without SlBO,it was statisti- cally different from the liver cirrhosis groups （P 〈 O. O1 ）. In 58 cases of liver cirrhosis intercurrent SBP patients, 25 patients with SIBO, the positive rate was 43.1%. In 22 cases of liver cirrhosis non-existence SBP, only 2 patients with SIBO, the positive rate was 9.1%. There were significant differences between them （P 〈 0.01 ）. After 2 weeks treament,25 cases of liver cirrhosis intercurrent SBP with SIBO patients, the SIBO in 20 cases was negative, 2 of cases which intercurrent SBP. SIBO in 5 patients is still positive,in them 4 cases intercurrent SBP. Conclusion The incidence of liver cirrhosis patients with SIBO was high, and it increased with the severity of liver damage, especially for the liver cirrhosis intercurrent SBP patients. The treatment of SI- BO can significantly reduce the incidence of SBP.