腹水浓缩联合抗生素对肝硬化合并腹水感染患者生化指标及疗效的影响

Effect of ascites concentration combined with antibiotics on biochemical indexes and therapeutic effect in patients with cirrhosis ascites infection

摘要:

探讨腹水浓缩联合抗生素对肝硬化合并腹水感染患者生化指标及疗效的影响。方法选取2012年5 月-2014 年12 月在该院就诊的肝硬化合并腹水感染患者58 例为研究对象，采用随机数字表法，分为实验组和对照组，各29例。实验组患者接受腹水浓缩联合抗生素治疗，对照组患者接受抗生素治疗，比较两组患者的临床症状、肝肾功能、肾素-血管紧张素-醛固酮系统（RAAS）、炎症程度、疗效。结果①临床疗效：实验组有效率为96.55%，高于对照组的75.86%（p <0.05）；②临床症状：实验组患者腹泻、腹痛、发热等消失时间短于对照组（p <0.05）；③肝肾功能：实验组患者血清总胆红素、谷丙转氨酶、谷草转氨酶、尿素氮、肌酐含量低于对照组（p <0.05）；④RAAS：实验组血清肾素、醛固酮、血管紧张素Ⅱ含量低于对照组（p <0.05）；⑤血清炎症因子：实验组患者的血清肿瘤坏死因子α、白细胞介素6、白细胞介素8、血清降钙素原含量低于对照组（p <0.05）；⑥并发症：实验组肝性脑病、肝肾综合征、消化道出血、电解质紊乱发生率低于对照组（p <0.05）。结论腹水浓缩联合抗生素有助于改善患者临床症状，减轻肝肾功能损伤，抑制RAAS 的激活，减轻炎症反应程度，降低并发症的发生率，提高疗效。

Abstract:

To study the effect of ascites concentration combined with antibiotics on biochemical indexes and therapeutic effect in patients with cirrhosis ascites infection. Methods Fifty-eight patients with cirrhosis ascites infection treated from May 2012 to December 2014 were randomly divided into experimental group and control group with 29 cases in each group. The patients in the experimental group received ascites concentration combined with antibiotic treatment, those in the control group received antibiotic treatment. Then clinical situation, liver and kidney functions, renin-angiotensin-aldosterone system (RAAS), inflammatory reaction and therapy effect were compared between the two groups. Results The effective rate in the experimental group (96.55%) was significantly higher than that in the control group (75.86%,p < 0.05). The time of disappearance of clinical symptoms (diarrhea, abdominal pain, fever, etc) in the experimental group was significantly shorter than that in the control group (p < 0.05). The serum levels of TBIL, ALT, AST, BUN and Scr in the experimental group were significantly lower than those in the control group (p < 0.05). The serum content of renin, aldosterone and angiotensin Ⅱin the experimental group was significantly lower than that in the control group (p <0.05). The serum levels of TNF-α, IL-6, IL-8 and PCT in the experimental group were significantly lower than those in the control group (p < 0.05). The incidences of hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding and electrolyte disorder in the experimental group were significantly lower than those in the control group (p < 0.05). Conclusions Ascites concentration combined with antibiotics helps to improve the clinical symptoms, reduce the damage to liver and kidney functions, inhibit RAAS activation, alleviate the degree of inflammatory reaction, prevent complications, and then improve therapeutic effect.