肝硬化腹水并自发性细菌性腹膜炎的危险因素分析

发布时间：2018-03-11 07:19

本文选题：肝硬化腹水　切入点：自发性细菌性腹膜炎　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：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:肝硬化病因(乙型肝炎、乙型肝炎合并酒精性、酒精性、丙型肝炎、自身免疫性、不明原因、血吸虫性),既往SBP史,是否并发肝性脑病,是否伴有呼吸道或者消化道感染,糖尿病史,有无上消化道出血,Child-pugh评分,血清白蛋白水平(ALB),白蛋白及球蛋白比值,血清总胆红素(TBIL),血钠水平(Na),血清的谷丙转氨酶(ALT)以及谷草转氨酶(AST),外周血血小板数值(PLT),腹水的白蛋白含量,凝血酶原时间(PT)以及性别、年龄等。分析危险因素相关性,为临床早期诊断和预防提供依据。方法:回顾性分析2012年-2014年在安医大第一附属医院消化内科以及感染科住院的肝硬化伴有腹水病人184例,其中并发SBP的78例患者纳入SBP组,未并发SBP的106例患者纳入非SBP组。收集相关的临床资料,对可能会对SBP的发生产生影响的因素进行单因素的分析,将有意义的因素进一步行多因素Logistic回归模型分析,有相关性的危险因素可以确定为独立高危因素。结果:单因素的分析结果表明血钠及血清总胆红素水平、合并肝性脑病、凝血酶原时间、Child-pugh评分以及既往SBP病史这6个因素在两组病人间对比差异均有显著性,具有统计学意义(P0.05),接着将有意义的因素进一步行多因素Logistic回归模型分析,分析的结果显示血钠水平、血清总胆红素及既往SBP病史是肝硬化腹水病人并自发性细菌性腹膜炎的独立危险因素(P=0.008、0.044、0.032)。结论:血钠水平、血清总胆红素及既往SBP病史是肝硬化腹水病人并自发性细菌性腹膜炎的独立高危因素,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。
[Abstract]:Objective: to study the risk factors of spontaneous bacterial peritonitis (SBP) in cirrhotic ascites patients: the etiology of cirrhosis (hepatitis B, hepatitis B with alcohol, alcohol, hepatitis C, autoimmunity, unknown cause). Schistosoma japonicum, history of SBP, hepatic encephalopathy, respiratory tract or digestive tract infection, diabetes mellitus, Child-pugh score, serum albumin level, albumin and globulin ratio. Serum total bilirubin TBILA, serum sodium level, serum alanine aminotransferase (alt), serum alanine aminotransferase (alt), peripheral blood platelet count (PLT), ascites albumin content, prothrombin time (PTT), sex, age and so on. Methods: from 2012 to 2014, 184 patients with ascites associated with cirrhosis and ascites in Department of Gastroenterology and infection Department, first affiliated Hospital of Anyi University, were analyzed retrospectively. Among them, 78 patients with SBP were included in SBP group. 106 patients without SBP were included in the non-#en1# group. The related clinical data were collected, and the factors that might affect the occurrence of SBP were analyzed by single factor analysis. The significant factors were further analyzed by multivariate Logistic regression model. Results: univariate analysis showed that serum sodium and serum total bilirubin levels were associated with hepatic encephalopathy. The Child-pugh score of prothrombin time and the past history of SBP were significantly different between the two groups (P 0.05). The significant factors were further analyzed by multivariate Logistic regression model. The results showed that serum sodium level, serum total bilirubin and previous history of SBP were the independent risk factors of ascitic cirrhosis patients with spontaneous bacterial peritonitis. Serum total bilirubin and previous history of SBP are independent risk factors for patients with ascites due to cirrhosis and spontaneous bacterial peritonitis. Patients with ascites due to cirrhosis with these high risk factors should be on high alert to the occurrence of SBP.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2;R572.2

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