细菌感染诱发肝性脑病的乙型肝炎肝硬化患者临床特点分析

摘要

Objective To analyze the clinical features of hepatic encephalopathy ( HE) induced by bacterial infection in patients with hepatitis B virus ( HBV)-related cirrhosis.Methods A total of 186 cases of patients with HBV-related cirrhosis and HE were divided into the infection group (59 cases) and non-infection group (127 cases) according to wheth-er the presence of bacterial infections.We observed the blood ammonia, serum albumin ( ALB) , alanine aminotransferase ( ALT) , total bilirubin ( TBIL) , international normalized ratio ( INR) , white blood cell ( WBC) , the percentage of neutro-phile granulocyte, serum creatinine ( Cr) and the mortality rate in the two groups.Results In the infection group, ammo-nia was (113.7 ±63.0)μmol/L, ALT was (206.3 ±86.4) U/L, TBIL was (113.7 ±62.9) mmol/L, WBC was (11.0 ±7.3) ×109/L, the percentage of neutrophile granulocyte was 79.6%±6.6%, Cr was (118.2 ±91.4) μmol/L, the Child-Pugh scores were (13 ±1) scores and the mortality rate was 40.6%.In the non-infection group, ammonia was (80.9 ±40.7) μmol/L, ALT was (114.2 ±20.9) U/L, TBIL was (80.9 ±40.7) mmol/L, WBC was (6.6 ±4.8) × 109/L, the percentage of neutrophile granulocyte was 61.4%±6.9%, Cr was (72.9 ±34.3) μmol/L, Child-Pugh scores were (10 ±1) scores and the mortality rate was 28.3%.Significant differences were found in the above indexes between the two groups ( all P<0.05) .Conclusions Serious liver damage is found in patients with HBV-related cirrhosis and HE induced by bacterial infection.Meanwhile, the patients have high ammonia, WBC, the percentage of neutrophile granulo-cyte levels and high mortality rate.%目的：分析细菌感染诱发肝性脑病的乙型肝炎肝硬化患者的临床特点。方法回顾性分析186例乙型肝炎肝硬化合并肝性脑病患者的临床资料，根据是否存在细菌感染的诱因将患者分为感染组（59例）和非感染组（127例）。观察两组血氨、白蛋白（ALB）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、国际标准化比率（INR）、白细胞（WBC）、中性粒细胞百分比、肌酐（Cr）、病死率。结果感染组血氨（113．7±63．0）μmol／L，ALT（206．3±86．4）U／L，TBIL（113．7±62．9）mmol／L，WBC（11．0±7．3）×109／L，中性粒细胞百分比79．6％±6．6％，Cr（118．2±91．4）μmol／L，Child-Pugh分级（13±1）分，病死率为40．6％。非感染组血氨（80．9±40．7）μmol／L，ALT（114．2±20．9）U／L，TBIL（80．9±40．7）mmol／L，WBC（6．6±4．8）×109／L，中性粒细胞百分比61．4％±6．9％，Cr（72．9±34．3）μmol／L，Child-Pugh分级（10±1）分，病死率为28．3％，两组比较，P均＜0．05。结论细菌感染诱发肝性脑病的乙型肝炎肝硬化患者肝损害重，血氨、WBC、中性粒细胞百分比、病死率高。