Spontaneous Bacterial Peritonitis-With Emphasis on Predisposing and Prognostic Factors

自發性細菌性腹膜炎－著重於致病因素和預後之研究

陳浩村(How-Tshung Chen) ； 王聖賢(Sun-Sang Wang) ； 盧啟文(Chi-Wen Lu) ； 李發耀(Fa-Yauh Lee) ； 趙毅(Yee Chao) ； 蔡養德(Yang-Te Tsai) ； 李壽東(Shou-Dong Lee) ； 黎國洪(Kwok-Hung Lai) ； 吳淑玲(Shwu-Ling Wu) ； 羅光瑞(Kwang-Juei Lo)

《中華民國消化系醫學會雜誌》 7卷3期 (1990/09) Pp. 144-149

https://doi.org/10.6557/GJTa.199009_7(3).0006

摘要

In order to find out the predisposing and prognostic factors of spontaneous bacterial peritonitis (SBP), 24 episodes of SBP in 21 cirrhotic patients were retrospectively reviewed and analyzed using the method of Feinstein. Possible predisposing factors such as previous paracentesis, endoscopy, sclerotherapy or associated infection were identified in 12 episodes of them. Factors associated with an adverse prognosis were BUN greater than 25mg/dl, creatinine greater than 2.1mg/dl, AST and/or ALT greater than 200 IU/L, shifting to left of leukocyte in peripheral blood in serum tests and a lower ascitic protein concentration less than 0.5gm/dl in ascitic fluid analysis. There were no distinctive symptom or sign influencing the mortality. Our data suggested that an impaired renal function rather than the infection itself predicted a poor prognosis of SBP, and invasive instrumentations possibly predisposed to the development of SBP in ascitic cirrhotics and should be considered.

關鍵字

自發性細菌性腹膜炎 ； 肝硬化 ； 腹水

並列摘要

In order to find out the predisposing and prognostic factors of spontaneous bacterial peritonitis (SBP), 24 episodes of SBP in 21 cirrhotic patients were retrospectively reviewed and analyzed using the method of Feinstein. Possible predisposing factors such as previous paracentesis, endoscopy, sclerotherapy or associated infection were identified in 12 episodes of them. Factors associated with an adverse prognosis were BUN greater than 25mg/dl, creatinine greater than 2.1mg/dl, AST and/or ALT greater than 200 IU/L, shifting to left of leukocyte in peripheral blood in serum tests and a lower ascitic protein concentration less than 0.5gm/dl in ascitic fluid analysis. There were no distinctive symptom or sign influencing the mortality. Our data suggested that an impaired renal function rather than the infection itself predicted a poor prognosis of SBP, and invasive instrumentations possibly predisposed to the development of SBP in ascitic cirrhotics and should be considered.

並列關鍵字

spontaneous bacterial peritonitis ； cirrhosis ； ascites