乙型肝炎肝硬化失代偿伴发细菌感染的危险因素分析

Analysis of risk factors of decompensated hepatitis B liver cirrhosis with bacterial infection

目的 探讨乙型肝炎肝硬化失代偿伴发细菌感染的危险因素,为乙型肝炎肝硬化失代偿期伴发细菌感染的预防、治疗措施的制订提供参考依据。方法 选择2019年3月至2020年12月中国人民解放军东部战区海军医院收治的乙型肝炎肝硬化失代偿期患者316例进行回顾性分析。收集可能引起乙型肝炎肝硬化失代偿伴发细菌感染的相关指标,由专业人员根据《全国临床检验操作规范》(第3版)进行致病菌培养。根据培养结果将患者分为阳性组与阴性组,比较两组患者上述各指标,并采用多因素Logistic回归分析判断各指标对乙型肝炎肝硬化失代偿伴发细菌感染的综合影响。结果 本次调查的316例乙型肝炎肝硬化失代偿期患者,发生细菌感染者共73例(23.10%),阴性243例(76.90%)。多因素Logistic回归分析结果显示:年龄>60岁、Child-Pugh分级C级、侵入性操作、腹水、消化道出血、血清白蛋白水平下降为乙型肝炎肝硬化失代偿伴发细菌感染的危险因素(P<0.05)。结论 乙型肝炎肝硬化失代偿伴发细菌感染发生率较高,其主要受患者年龄、Child-Pugh分级、侵入性操作等因素的影响,临床上可根据上述因素制订针对性的干预措施以降低此类患者细菌感染发生率。

Objective To explore the risk factors of bacterial infection associated with decompensated hepatitis B liver cirrhosis,and provide a reference for the formulation of prevention and treatment measures for bacterial infection associated with decompensated hepatitis B liver cirrho.Method A retrospective analysis of 316 patients with hepatitis B and liver cirrhosis who were admitted to Naval Hospital,Eastern theater of PLA from March 2019 to December 2020 in the decompensated period.Collect relevant indicators that may cause decompensation of hepatitis B liver cirrhosis accompanied by bacterial infection and cultivate pathogenic bacteria by professionals in accordance with the "National Clinical Laboratory Practice Code (3rd Edition)".According to the culture result,the patients were divided into positive group and negative group.The above indicators were compared between the two groups.Multivariate Logistic regression analysis was used to determine the comprehensive influence of each indicator on decompensated hepatitis B liver cirrhosis with bacterial infection.Result Among the 316 patients with hepatitis B liver cirrhosis in the decompensated stage of this investigation,a total of 73 cases (23.10%) were infected,243 were negative (76.90%).The result of multivariate logistic regression analysis showed that age>60 years old,child Pugh C,invasive operation,ascites,gastrointestinal bleeding,serum albumin level decreased as risk factors of bacterial infection in patients with decompensated hepatitis B cirrhosis (P<0.05).Conclusion The incidence of decompensated hepatitis B liver cirrhosis accompanied by bacterial infection is relatively high,which is mainly affected by the patient’s age,Child-Pugh classification,invasive operation and other factors,and clinically targeted interventionscan be developed to reduce the incidence of bacterial infections among these patients based on the thesefactors.