细菌感染诱发肝性脑病乙型肝炎肝硬化临床特点研究

Clinical characteristics of hepatitis B liver cirrhosis patients with bacterial infection-induced hepatic encephalopathy

目的研究乙型肝炎肝硬化患者细菌感染诱发肝性脑病临床特点,为提高临床疗效提供依据。方法选取2015年1-8月医院诊治的40例乙型肝炎肝硬化细菌感染诱发肝性脑病患者临床资料进行分析,将其设为试验组,选取同期治疗的40例单纯性乙型肝炎肝硬化患者为对照组,患者入院均检测血氨、血清白蛋白、肝功能等生化指标,分析乙型肝炎肝硬化患者细菌感染诱发肝性脑病临床特点。结果试验组患者血清白蛋白水平显著低于对照组(P<0.05);血氨、丙氨酸氨基转移酶、总胆红素、肌酐、国际标准化比率及白细胞指标显著高于对照组(P<0.05);试验组患者不同感染部位的肝性脑病分级差异有统计学意义(P<0.05);对于腹膜炎、呼吸道、尿道及皮肤组织感染患者的3、4级与1、2级肝性脑病相比差异有统计学意义(P<0.05)。结论乙型肝炎肝硬化患者细菌感染诱发肝性脑病后病情更加严重,对肝脏的损害更大,临床治疗时应该引起重视,以降低病死率。

OBJECTIVE To explore the clinical characteristics of the hepatitis B liver cirrhosis patients with bacterial infection-induced hepatic encephalopathy so as to provide guidance for improvement of clinical efficacy.METHODS A total of 40 hepatitis B liver cirrhosis patients with bacterial infection-induced hepatic encephalopathy who were treated in the hospital from Jan 2015 to Aug 2015 were enrolled in the study and set as the experimental group,meanwhile,40 patients with single hepatitis B liver cirrhosis were assigned as the control group.The biochemical indicators such as the blood ammonia,serum albumin,and transaminase were detected at admission to the hospital;the clinical characteristics of the hepatitis B liver cirrhosis patients with bacterial infection-induced hepatic encephalopathy were observed.RESULTS The level of serum albumin of the experimental group was significantly lower than that of the control group（P0.05）.The levels of blood ammonia,alanine aminotransferase,total bilirubin,creatinine,and white blood cells as well as international normalized ratio were significantly higher in the experimental group than in the control group（P0.05）.There was significant difference in the grade of hepatic encephalopathy among the patients with different sites of infections in the experimental group（P0.05）;there was significant difference in the grade 3,4,1,or 2hepatic encephalopathy among the patients with peritonitis,respiratory tract infections,urinary tract infections,and skin soft tissue infections（P0.05）.CONCLUSIONThe bacterial infection-induced hepatic encephalopathy may exacerbate the illness condition of the patients with hepatitis B liver cirrhosis and lead to greater damage to the liver;it is necessary to pay attention during the clinical treatment so as to reduce the mortality rate.