肝硬化患者自发性细菌性腹膜炎腹水感染的相关因素分析

Related factors for spontaneous bacterial peritonitis in patients with liver cirrhosis

目的分析肝硬化患者自发性细菌性腹膜炎(SBP)腹水感染的相关因素,为临床防治肝硬化SBP提供依据。方法回顾性分析2009年1月-2013年10月收治的783例肝硬化腹水患者的临床资料,根据是否发生SBP分为研究组88例和对照组695例,对并发SBP的相关因素进行单因素和多因素logistic分析。结果共88例发生SBP,发生率为11.2%;单因素分析结果显示,两组患者的性别、年龄、糖尿病、天冬门氨酸氨基转移酶和门静脉直径等因素比较,差异无统计学意义;两组患者上消化道出血、腹泻、腹水蛋白含量(ALB)、血清总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、凝血酶原活度(PTA)和Child-Pugh分级等因素比较,差异有统计学意义(P<0.05);多因素分析结果显示,上消化道出血、腹泻、ALB<10g/L和TBIL>50μmol/L是肝硬化患者并发SBP的危险因素。结论肝硬化患者并发SBP与多种因素密切相关,临床应注意观察以上指标,采取相应的治疗措施,降低SBP发生率,做到早诊断早治疗,保障患者生命安全。

OBJECTIVE To analyze the related factors for the spontaneous bacterial peritonitis （SBP） in the patients with liver cirrhosis so as to provide guidance for clinical prevention of liver cirrhosis complicated with SBP . METHODS The clinical data of 783 patients with cirrhotic ascites who were treated from Jan 2009 to Oct 2013 were retrospectively analyzed ,then the patients were divided into the study group with 88 cases and the control group with 695 cases according to the status of SBP ,and the univariate analysis and the multivariate logistic analy-sis were performed for the related factors of SBP .RESULTS The SBP occurred in totally 88 cases with the inci-dence rate of 11 .2% .The results of the univariate analysis showed that there was no statistically significant differ-ence in the gender ,age ,diabetes ,aspartate aminotransferase ,or portal vein diameter between the two groups and that there was statistically significant difference in the upper gastrointestinal bleeding ,diarrhea ,ascites protein content ,total bilirubin （TBIL） ,alanine aminotransferase ,prothrombin activity （PTA） ,or Child-Pugh classifica-tion between the two groups （P〈0 .05） .The results of multivariate analysis indicated that the upper gastrointes-tinal bleeding ,diarrhea ,level of alanine aminotransferase less than 10g/L ,and level of TBIL more than 50μmol/L were the risk factors for SBP in the patients with liver cirrhosis .CONCLUSION he SBP in the patients with liver cirrhosis is closely associated with multiple factors ,and it is necessary for the hospital to pay attention to the a-bove indicators and take corresponding treatment measures so as to reduce the incidence of SBP ,perform the diag-nosis and treatment in early stage ,and ensure the safety of life of the patient .