慢加急性肝衰竭合并自发性细菌性腹膜炎的危险因素分析

刘政芳; 黄伟; 李芹

doi:10.3969/j.issn.1001-5256.2017.04.024

慢加急性肝衰竭合并自发性细菌性腹膜炎的危险因素分析

DOI: 10.3969/j.issn.1001-5256.2017.04.024

1. 福州市传染病医院中西医结合肝病科
2. 福建中医药大学

基金项目:

“十二五”国家重大科技专项(2012ZX10005-005)；福州市科技计划项目(2013-S-125-7)；

详细信息

中图分类号: R575.3;R572.2
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出版历程
- 收稿日期: 2016-11-16
- 出版日期: 2017-04-20

A risk factors analysis of acute-on-chronic liver failure complicated by spontaneous bacterial peritonitis

Department of Traditional and Western Medical Hepatology, Fuzhou Infectious Disease Hospital

Research funding:

摘要

摘要:
目的探讨慢加急性肝衰竭（ACLF）患者出现自发性细菌性腹膜炎（SBP）的相关影响因素,为临床诊断及预后判断提供参考。方法回顾分析2009年1月-2014年12月于福州市传染病医院住院治疗的667例ACLF患者的临床资料,根据是否合并SBP分为ACLF组（n=232）和ACLF合并SBP组（n=435）。比较分析2组患者的一般资料、实验室指标以及相关并发症发生情况。服从正态分布的计量资料2组间比较采用t检验,不服从正态分布的计量资料2组间比较采用Mann-Whitney U检验;计数资料2组间比较采用χ2检验,ACLF合并SBP的独立危险因素采用logistic回归分析。结果 2组患者的实验室指标和并发症比较结果显示,在Alb（t=-4.110,P<0.001）、ALT（U=-6.653、P<0.001）、AST(t=-8.045,P<0.001、血钠（t=-2.879,P=0.006）、PTA（t=-2.140,P=0.037）、INR（t=1.453,P=0.042）、Hb（t=-3.446,P=0.001）以及上消化道出血、肝肾综合征、肺部感...
- 肝功能衰竭 /
- 腹膜炎 /
- 危险因素
Abstract:
Objective To investigate the influencing factors for spontaneous bacterial peritonitis (SBP) in patients with acute-on-chronic liver failure (ACLF) , and to provide a reference for clinical diagnosis and prognosis evaluation.Methods A retrospective analysis was performed for the clinical data of 667 patients with ACLF who were hospitalized and treated in our hospital from January 2009 to December2014, and according to the presence or absence of SBP, they were divided into ACLF group (n=232) and ACLF-SBP group (n=435) .The general information, laboratory markers, and incidence of complications were compared between the two groups.The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups, and a logistic regression analysis was used to identify independent risk factors for ACLF complicated by SBP.Results The comparison of laboratory markers and comorbidities showed that there were significant differences between the two groups in albumin (Alb) (t=-4.110, P<0.001) , alanine aminotransferase (U=-6.653, P<0.001) , aspartate aminotransferase (t=-8.045, P<0.001) , blood sodium (t=-2.879, P=0.006) , prothrombin time activity (t=-2.140, P=0.037) , international normalized ratio (t=1.453, P=0.042) , hemoglobin (t=-3.446, P=0.001) , upper gastrointestinal bleeding (χ2=48.252, P=0.002) , hepatorenal syndrome (χ2=16.244, P=0.031) , and pulmonary infection (χ2=13.564, P<0.001) .The multivariate logistic regression analysis showed that there were significant differences in Alb (OR=1.119, 95% CI: 1.052 ~ 1.189) , platelet count (PLT) (OR=1.035, 95% CI: 0.755 ~ 1.084) , upper gastrointestinal bleeding (OR=1.117, 95% CI: 0.072 ~ 1.135) , and pulmonary infection (OR=2.275, 95% CI: 0.978 ~ 5.292) (P=0.002, 0.038, 0.022, and0.036) .Conclusion In the treatment of ACLF patients, risk factors including low Alb, low PLT, upper gastrointestinal bleeding, and pulmonary infection should be prevented, and early diagnosis and intervention of these risk factors helps to reduce the incidence of SBP.
- liver failure /
- peritonitis /
- risk factors

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