肝硬化患者自发性腹膜炎后肾功能的

    变化与预后的关系

    王义国, 闫明先, 张建娜

    (山东省千佛山医院, 山东 济南 250014)

    摘要: 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(R I)的演变过程与死亡率的关系。结果 有SBP

    的患者肾功能损害(SBP2 R I)发生率明显高于无SBP 患者肾功能损害发生率(P < 0. 001) , 63 例发生SBP2 R I的患

    者中, 进展型SBP2 R I占 36. 51% ,稳定型SBP2 R I占 33. 33% ,一过型SBP2 R I占 30. 16% , 进展型和稳定型SBP2

    R I死亡率(73. 91%、 42. 86%)显著高于无SBP2 R I者(16. 16%) , 一过型SBP2 R I(15. 79%)不增加死亡率。结论

    SBP2 R I的主要原因是感染, 它的高死亡率与肾损害程度直接相关。

    关键词: 肝硬化; 自发性腹膜炎; 肾功能损害; 预后

    中图分类号: R575. 2 文献标识码: A 文章编号: 100524529 (2002) 0920658202

    The Rela t ion sh ip between the Changes in Rena l Funct ion and Prognos is

    among Hosp ita l ized Cirrhot ic Pa t ien ts with Spon taneous Bacter ia l Per iton it is

    WAN G Yi2 guo, YAN M ing2 x ian, ZHAN G J ian2 na

    (D ep a rtm en t of Gastroen terology , S hand ong P rov incia l Q ianf oshan H osp ita l, J inan 250014, Ch ina)

    Abstract : OBJECTIVE To study the changes in renal funct ion in cir rho t ic pat ients w ith spontaneous bacter ial

    per itonit is (SBP ) in ho sp ital and to invest igate the relat ionsh ip betw een them and the pat ients′p rogno sis .

    METHODS The changes in renal funct ion and the relat ionsh ip betw een renal impairment (R I) clinic course and

    mo r tality in 162 cir rho t ic pat ientsw ith SBP w ere analyzed . RESULTS The renal impairment incidence of cir rho t ic

    pat ientsw ith SBP (SBP2 R I ) is signif icant ly h igher than that of pat ientsw ithout SBP (P < 0. 001). Among 63 pa2

    t ients occur red SBP2 R I, 36. 51% pat ients are w ith p rogressive SBP2 R I, 33. 33% w ith steady one and 30. 16%

    w ith t ransient one . The mo r tality of p rogressive and steady SBP2 R I (73. 91% , 42. 86%) is signif icant ly h igher

    w h ile the mo r tality of t ransient SBP2 R I (15. 79%) is lesser than that of pat ients w ithout SBP2 R I (16. 16%).

    CONCLUSIONS Themain cause of SBP2 R I is infect ion . The h ighermo r tality of SBP2 R I has co r relatedw ith renal

    impairment .

    Key words : Cir rho sis; Spontaneous bacter ial per itonit is; Renal impairment; P rogno sis

    自发性腹膜炎(SBP)是肝硬化的严重并发症之

    一, 也是促使肝硬化严重肾损害的主因, 我们研究了

    医院感染SBP 后肾功能的变化及其与预后的关系,旨在进一步提高肝硬化 SBP 后肾功能损害(SBP2

    R I)的诊治水平 ......