中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2010年
2期
73-75
,共3页
肝功能衰竭%肝炎,乙型,慢性%细菌感染%真菌感染%预后
肝功能衰竭%肝炎,乙型,慢性%細菌感染%真菌感染%預後
간공능쇠갈%간염,을형,만성%세균감염%진균감염%예후
Liver failure%Chronic hepatitis B%Bacterial infection%Fungal infection%Prognosis
目的 分析乙型肝炎慢加急性肝功能衰竭(acute-on-chronic liver failure,ACLF)患者合并感染的特点及其对疾病转归的影响,并探讨合并感染的相关因素.方法 对2007年1-12月中山大学附属第三医院收治的186例ACLF患者进行回顾性调查,分析感染常见部位、临床和病原学特点及其对预后的影响.采用非条件Logistic回归方法分析感染相关因素.结果 在186例ACLF患者中,合并感染160例(86.0%),常见感染部位为腹腔、胆道、肺部和肠道.血清白蛋白(Alb)≤30 g/L、总胆红素(TBil)>342 μmol/L、凝血酶原时间(PT)>28 s以及存在其他肝功能衰竭(肝衰竭)等严重并发症者有更高的感染率(χ~2值分别为5.4、7.3、21.3和14.7,P值均<0.05).ACLF合并感染者的病死率为74.5%(119/160),未合并感染者的病死率为42.3%(11/26),差异具有统计学意(χ~2=10.9,P=0.000);合并多部位感染者的病死率(79.8%,79/99)明显高于单部位感染者(65.6%,40/61),差异同样具有统计学意义(χ~2=4.0,P=0.045).结论 ACLF患者感染发生率高,且与病情的严重程度密切相关.
目的 分析乙型肝炎慢加急性肝功能衰竭(acute-on-chronic liver failure,ACLF)患者閤併感染的特點及其對疾病轉歸的影響,併探討閤併感染的相關因素.方法 對2007年1-12月中山大學附屬第三醫院收治的186例ACLF患者進行迴顧性調查,分析感染常見部位、臨床和病原學特點及其對預後的影響.採用非條件Logistic迴歸方法分析感染相關因素.結果 在186例ACLF患者中,閤併感染160例(86.0%),常見感染部位為腹腔、膽道、肺部和腸道.血清白蛋白(Alb)≤30 g/L、總膽紅素(TBil)>342 μmol/L、凝血酶原時間(PT)>28 s以及存在其他肝功能衰竭(肝衰竭)等嚴重併髮癥者有更高的感染率(χ~2值分彆為5.4、7.3、21.3和14.7,P值均<0.05).ACLF閤併感染者的病死率為74.5%(119/160),未閤併感染者的病死率為42.3%(11/26),差異具有統計學意(χ~2=10.9,P=0.000);閤併多部位感染者的病死率(79.8%,79/99)明顯高于單部位感染者(65.6%,40/61),差異同樣具有統計學意義(χ~2=4.0,P=0.045).結論 ACLF患者感染髮生率高,且與病情的嚴重程度密切相關.
목적 분석을형간염만가급성간공능쇠갈(acute-on-chronic liver failure,ACLF)환자합병감염적특점급기대질병전귀적영향,병탐토합병감염적상관인소.방법 대2007년1-12월중산대학부속제삼의원수치적186례ACLF환자진행회고성조사,분석감염상견부위、림상화병원학특점급기대예후적영향.채용비조건Logistic회귀방법분석감염상관인소.결과 재186례ACLF환자중,합병감염160례(86.0%),상견감염부위위복강、담도、폐부화장도.혈청백단백(Alb)≤30 g/L、총담홍소(TBil)>342 μmol/L、응혈매원시간(PT)>28 s이급존재기타간공능쇠갈(간쇠갈)등엄중병발증자유경고적감염솔(χ~2치분별위5.4、7.3、21.3화14.7,P치균<0.05).ACLF합병감염자적병사솔위74.5%(119/160),미합병감염자적병사솔위42.3%(11/26),차이구유통계학의(χ~2=10.9,P=0.000);합병다부위감염자적병사솔(79.8%,79/99)명현고우단부위감염자(65.6%,40/61),차이동양구유통계학의의(χ~2=4.0,P=0.045).결론 ACLF환자감염발생솔고,차여병정적엄중정도밀절상관.
Objective To investigate the characteristics of secondary infections in hepatitis B patients with acute-on-chronic liver failure(ACLF)and its impact on the prognosis. Methods Infection sites, clinical and etiological characteristics were retrospectively reviewed in 186 hospitalized patients with ACLF from the Third Affiliated Hospital of Sun Yat-sen University during January to December 2007. Logistic regression was used to analyze risk factors of secondary infections. Results In 186 patients with ACLF, 160 patients(86.0%) were complicated with infections, and the common sites of infections were abdominal cavity, biliary tract, lung and intestinal tract. The rates of secondary infections were higher in patients with serum albumin(Alb)≤30 g/L, total bilirubin(TBil)>342 μmol/L, prothrombin time(PT)>28 seconds, and those complicated with one or more complications(χ~2=5.4, 7.3, 21.3 and 14.7, P<0.05). The fatality rates of patients with and without infections were 74. 5%(119/160) and 42.3%(11/26), respectively, and the difference was of statistical significance(χ~2=10.9,P=0.000). Patients with multi-organ infections had a higher fatality rate(79.8%, 79/99)than those with one organ infections(65.6%, 40/61), and the difference was also significant(χ~2=4.0, P=0.045). Conclusion Patients with ACLF are liable to infection, and the severity is closely related with the prognosis.
