CAJ | 학술논문

目的调查病毒性肝炎后肝硬化住院患者的感染率和感染源,评估感染的危险因素.方法采用横断面研究,连续收集382例病毒性肝炎后肝硬化住院患者,查阅患者相关临床资料,采用单因素分析、逻辑回归分析等方法分析患者感染相关因素和独立危险因素,微生物培养和鉴定分析感染源.结果通过调查统计肝硬化住院患者感染率20.2％,77名患者感染,最常见感染是自发性细菌性腹膜炎(27例),感染显著增加患者的死亡(22.1％vs.4.3％,P≤0.001)和延长住院时间(10 d vs.22 d,P≤0.001).逻辑回归分析显示胃肠道出血和低白蛋白血症是肝硬化住院患者感染独立危险因素；共分离出66株菌,革兰阴性菌38株,革兰阳性菌26株,真菌2株.结论感染增加病毒性肝炎后肝硬化住院患者死亡；胃肠道出血和低白蛋白血症是导致肝硬化住院患者感染独立危险因素.
목적 조사병독성간염후간경화주원환자적감염솔화감염원,평고감염적위험인소.방법 채용횡단면연구,련속수집382례병독성간염후간경화주원환자,사열환자상관림상자료,채용단인소분석、라집회귀분석등방법분석환자감염상관인소화독립위험인소,미생물배양화감정분석감염원.결과 통과조사통계간경화주원환자감염솔20.2％,77명환자감염,최상견감염시자발성세균성복막염(27례),감염현저증가환자적사망(22.1％vs.4.3％,P≤0.001)화연장주원시간(10 d vs.22 d,P≤0.001).라집회귀분석현시위장도출혈화저백단백혈증시간경화주원환자감염독립위험인소；공분리출66주균,혁란음성균38주,혁란양성균26주,진균2주.결론 감염증가병독성간염후간경화주원환자사망；위장도출혈화저백단백혈증시도치간경화주원환자감염독립위험인소.
Objective To investigate the infection rate in hospitalized patients with posthepatitic cirrhosis and to assess the risk factors of infections.Methods The prospective study was performed to assess the risk of infection in 382 hospitalized patients with posthepatitic cirrhosis.The clinical and laboratory data were collected.Univariate analysis and Logistic regression were used to analyse the risk fachors and independent risk factors of infections.Results 20.2％ patients developed an infection during their hospitalization.Spontaneous bacterial peritonitis (SBP) (35.1％) were the most common infections.Death in patients with infections was higher than that of non-infection patients (22.1％ vs.4.3％,P ≤ 0.001).Logistic regression identified gastrointestinal bleeding (A =4.2,95％ CI =1.8-10.7) and a low serum albumin (OR =1.4,95％ CI =1.05-1.23) as the only two variables independently associated with the development of an infection.There were 66 isolates isolated including 38 gram-negtive bacteria,26 gram-positive bacteria,and 2 fungi.Conclusion Infections could increase the death rate in patients with posthepatitic cirrhosis.Patients with posthepatitic cirrhosis who were admitted for gastrointestinal bleeding and low serum albumin level have a higher risk of developing a infection during their hospitalization than other cirrhotic patients.