肝硬化患者自发性腹膜炎后肾功能的变化与预后的关系

The Relationship between the Changes in Renal Function and Prognosis among Hospitalized Cirrhotic Patients with Spontaneous Bacterial Peritonitis

目的 探讨肝硬化腹水患者医院感染自发性腹膜炎 (SBP)后肾功能的变化及其与预后的关系。方法 观察 162例医院感染 SBP患者的肾功能的变化 ,分析肾功能损害 (RI)的演变过程与死亡率的关系。结果 有 SBP的患者肾功能损害 (SBP-RI)发生率明显高于无 SBP患者肾功能损害发生率 (P<0 .0 0 1) ,63例发生 SBP-RI的患者中 ,进展型 SBP-RI占 3 6.5 1% ,稳定型 SBP-RI占 3 3 .3 3 % ,一过型 SBP-RI占 3 0 .16% ,进展型和稳定型 SBP-RI死亡率 (73 .91%、42 .86% )显著高于无 SBP-RI者 (16.16% ) ,一过型 SBP-RI(15 .79% )不增加死亡率。结论 SBP-RI的主要原因是感染 。

OBJECTIVE To study the changes in renal function in cirrhotic patients with spontaneous bacterial peritonitis(SBP) in hospital and to investigate the relationship between them and the patients′ prognosis. METHODS The changes in renal function and the relationship between renal impairment (RI) clinic course and mortality in 162 cirrhotic patients with SBP were analyzed. RESULTS The renal impairment incidence of cirrhotic patients with SBP (SBP RI) is significantly higher than that of patients without SBP (P<0.001). Among 63 patients occurred SBP RI, 36.51% patients are with progressive SBP RI, 33.33% with steady one and 30.16% with transient one. The mortality of progressive and steady SBP RI (73.91%, 42.86%) is significantly higher while the mortality of transient SBP RI (15.79%) is lesser than that of patients without SBP RI (16.16%). CONCLUSIONS The main cause of SBP RI is infection. The higher mortality of SBP RI has correlated with renal impairment.