肝硬化腹水并自发性细菌性腹膜炎的危险因素分析

Analysis of risk factors of cirrhotic ascites accompanied by spontaneous bacterial peritonitis

目的研究肝硬化腹水患者并发自发性细菌性腹膜炎(SBP)的多种危险因素,为临床早期诊断和预防提供依据。方法回顾性分析肝硬化腹水患者184例,其中78例并发SBP(SBP组),106例未并发SBP(非SBP组),收集相关临床资料,对可能影响SBP发生的因素进行单因素分析及多因素Logistic回归模型分析。结果单因素分析结果显示SBP病史、血清总胆红素水平、Child-pugh评分、凝血酶原时间、血钠水平、合并肝性脑病6个因素在两组患者间比较差异均有统计学意义(P<0.05)。将有意义的单因素进一步行Logistic回归分析,结果表明SBP病史、血清总胆红素水平、血钠水平是肝硬化腹水并发SBP的独立高危因素。结论SBP病史、血清总胆红素水平、血钠水平是肝硬化腹水患者并发SBP的独立危险因素,对有这些高危因素的肝硬化腹水患者,应高度警惕SBP的发生。

Objective To provide the basis for diagnosis and prevention in early clinic, the writer researched into the various risk factors of the patients who got cirrhotic ascites accompanied by spontaneous bacterial peritonitis （SBP）. Methods Analyze retrospectively 184 cases of patients who suffered cirrhosis with ascites, among which 78 cases belonged to SBP,while 106 cases were defined as non-SBP. What＇s more ,having collected the relevant clinical data, the author analyzed the factors that might affect the occurrence of SBP, which were divided into two aspects-the analysis of single factors and multi-factors calledlogistic regression model. Results The analysis of the single factor showed that there existed six factors, including clinical history of SBP, serum total bilirubin level, Childpugh score system, cirrhosis with ascites, serum sodium level and hepaticencephalopathy. Every factor was significant difference between two group. The meaningful single factor was analyzed by the Logistic regression analysis, further. The result showed that clinical history of SBP, serum total bilirubin level, and serum sodium level were the independent risk factors of cirrhosis with ascites accompanied by SBP. Conclusion The history of SBP, serum total bilirubin level, and serum sodium level are the independent risk factors of cirrhosis with ascites accompanied by SBP, the patients with liver cirrhosis and ascites with these high risk factors should be highly vigilant to SBP occurfence.