肝硬化腹水合并自发性细菌性腹膜炎的病原学及危险因素分析
发布时间：2018-09-18 16:46
【摘要】：目的探讨肝硬化腹水合并自发性细菌性腹膜炎(SBP)的病原学特点及危险因素。方法回顾性分析医院2012年1月-2015年6月收治124例肝硬化腹水并发SBP患者的临床资料,对患者的临床表现、实验室病原学检查结果,同时对所有患者的临床病理因素采用Logistic回归分析,分析其发病的危险因素。结果患者主要表现包括发热、腹胀、腹痛;124例患者中共有81例细菌培养结果为阳性,阳性率为65.32%,共检出病原菌88株,其中革兰阳性55株占62.50%,革兰阴性菌31株占35.23%,真菌2株占2.27%;对患者的性别、年龄、临床表现、是否合并有消化道出血、血常规WBC水平、腹水常规WBC水平、白蛋白水平进行统计分析,经单因素分析,血清白蛋白、腹水WBC、腹水白蛋白以及伴有消化道出血与SBP发生具有密切的关系(P0.05);经过Logistic多因素回归分析结果显示,消化道出血和腹水蛋白是肝硬化腹水患者并发SBP的独立危险因素(P0.05)。结论肝硬化腹水合并自发性细菌性腹膜炎患者主要为革兰阳性菌感染导致,其中表皮葡萄球菌感染较为多见,患者腹水蛋白≤10g/L和消化道出血是发病的独立危险因素。
[Abstract]:Objective to investigate the etiological characteristics and risk factors of cirrhotic ascites with spontaneous bacterial peritonitis (SBP). Methods the clinical data of 124 patients with cirrhotic ascites complicated with SBP from January 2012 to June 2015 were retrospectively analyzed. The clinicopathological factors of all patients were analyzed by Logistic regression analysis. Results the main manifestations of the patients included fever, abdominal distension and abdominal pain. Among 124 patients with abdominal pain, 81 cases were positive in bacterial culture, and the positive rate was 65.32. 88 strains of pathogenic bacteria were detected. Among them, 55 Gram-positive strains accounted for 62.50%, 31 Gram-negative bacteria accounted for 35.233,2.27.The gender, age, clinical manifestations, gastrointestinal bleeding, blood routine WBC level, and ascites routine WBC level were observed in the patients. The serum albumin, ascites WBC, ascites albumin and gastrointestinal bleeding were closely related to the occurrence of SBP by univariate analysis (P0.05), and the results of multivariate Logistic regression analysis showed that the serum albumin, ascitic fluid albumin in ascites and gastrointestinal bleeding were closely related to the occurrence of SBP (P0.05). Gastrointestinal hemorrhage and ascites protein were independent risk factors of SBP in patients with cirrhosis and ascites (P0.05). Conclusion the patients with cirrhosis and ascites with spontaneous bacterial peritonitis are mainly caused by Gram-positive bacteria infection, among which Staphylococcus epidermidis infection is more common. Ascites protein 鈮，
本文编号：2248520
[Abstract]:Objective to investigate the etiological characteristics and risk factors of cirrhotic ascites with spontaneous bacterial peritonitis (SBP). Methods the clinical data of 124 patients with cirrhotic ascites complicated with SBP from January 2012 to June 2015 were retrospectively analyzed. The clinicopathological factors of all patients were analyzed by Logistic regression analysis. Results the main manifestations of the patients included fever, abdominal distension and abdominal pain. Among 124 patients with abdominal pain, 81 cases were positive in bacterial culture, and the positive rate was 65.32. 88 strains of pathogenic bacteria were detected. Among them, 55 Gram-positive strains accounted for 62.50%, 31 Gram-negative bacteria accounted for 35.233,2.27.The gender, age, clinical manifestations, gastrointestinal bleeding, blood routine WBC level, and ascites routine WBC level were observed in the patients. The serum albumin, ascites WBC, ascites albumin and gastrointestinal bleeding were closely related to the occurrence of SBP by univariate analysis (P0.05), and the results of multivariate Logistic regression analysis showed that the serum albumin, ascitic fluid albumin in ascites and gastrointestinal bleeding were closely related to the occurrence of SBP (P0.05). Gastrointestinal hemorrhage and ascites protein were independent risk factors of SBP in patients with cirrhosis and ascites (P0.05). Conclusion the patients with cirrhosis and ascites with spontaneous bacterial peritonitis are mainly caused by Gram-positive bacteria infection, among which Staphylococcus epidermidis infection is more common. Ascites protein 鈮，
本文编号：2248520
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