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目的 探讨慢性重型肝炎(CSVH)并发自发性腹膜炎(SBP)后肾脏损害和肾脏损害加重(SBPRI)的临床特点、转归及影响因素。方法 对129例慢性重型肝炎并发自发性腹膜炎住院患者资料进行回顾性分析。结果 慢性重型肝病人常伴有SBPRI,患者年龄越大、病程越长、合并其他感染或糖尿病、SBP前已发生肾损害时病情越重,越易于发生SBPRI,且直接影响到病人的预后。SBP前血尿素氮(BUN)值越高、血Na+值越低、对抗生素治疗反应不良者,预后越不佳。结论 SBPRI的肾损害是功能性的,可以迅速恶化,也可以随着SBP的好转而稳定或好转。
Objective To investigate the clinical characteristics, outcome and influencing factors of renal damage and aggravated renal damage (SBPRI) after chronic severe hepatitis (CSVH) complicated with spontaneous peritonitis (SBP). Methods The data of 129 patients with chronic severe hepatitis complicated with spontaneous peritonitis were analyzed retrospectively. Results Patients with chronic severe liver disease often had SBPRI. The older the patient, the longer the course of the disease, the more complicated with other infections or diabetes mellitus. The more serious renal damage occurred before SBP, the more prone to SBPRI, which directly affected the prognosis of patients. The higher the pre-SBP blood urea nitrogen (BUN) value, the lower the blood Na + value, the less responsive to the antibiotic treatment, the worse the prognosis. Conclusions The renal impairment of SBPRI is functional and can rapidly worsen. It can also stabilize or improve as SBP improves.