肝硬化合并腹腔感染病原菌分布特点及相关因素研究

Study on the distribution characteristics and related factors of pathogens in liver cirrhosis complicated with peritoneal infection

摘要:

目的 研究肝硬化合并腹腔感染患者病原菌分布特点，并分析其相关因素。方法 选取2022年10月—2025年10月联勤保障部队第九二三医院收治的86例肝硬化患者为研究对象。采用回顾性分析方法，记录腹腔感染和病原菌分布。采用Lasso-Logistic多因素回归模型分析肝硬化合并腹腔感染的相关因素，并根据分析结果构建风险回归方程。结果 86例患者合并腹腔感染者18例（20.93%）；共检出病原菌32株，其中，革兰阴性菌21株，革兰阳性菌11株。Lasso-Logistic多因素分析显示，Child Pugh分级C级、中性粒细胞与淋巴细胞比值（NLR）异常升高是肝硬化合并腹腔感染的独立危险因素（P 0.05），预防性应用抗生素是肝硬化合并腹腔感染的独立保护因素（P 0.05）。受试者工作特征曲线分析显示，风险回归方程判断肝硬化合并腹腔感染的曲线下面积为0.840，敏感性为88.9%，特异性为72.1%。结论 肝硬化合并腹腔感染者病原菌以革兰阴性菌为主，其发生与患者Child Pugh分级、NLR水平及是否进行预防性抗生素干预有关，据此构建的风险回归方程具有较好的预测效能。

Abstract:

Objective To investigate the distribution characteristics of pathogenic bacteria in patients with liver cirrhosis complicated with peritoneal infection, and to analyze the related factors for liver cirrhosis complicated with peritoneal infection.Methods 86 patients with liver cirrhosis admitted to the 923rd Hospital of the Joint Logistic Support Force from October 2022 to October 2025 were selected, and a retrospective analysis was conducted. The occurrence of abdominal infection and the distribution of pathogenic bacteria were recorded. The Lasso-Logistic multivariate regression model was used to analyze the related factors for liver cirrhosis complicated with peritoneal infection, a risk regression equation was constructed based on the results of multivariate analysis.Results Among the 86 patients, 18 cases were complicated with peritoneal infection, accounting for 20.93%. A total of 32 strains of pathogenic bacteria were detected, including 21 strains of Gram-negative bacteria and 11 strains of Gram-positive bacteria. Lasso-Logistic multivariate analysis showed that Child-Pugh grade C and abnormally elevated neutrophil-to-lymphocyte ratio (NLR) were independent risk factors for liver cirrhosis complicated with peritoneal infection, while prophylactic use of antibiotics was an independent protective factor (P 0.05). The receiver operating characteristic curve analysis showed that the area under the curve (AUC) of this risk regression equation for diagnosing liver cirrhosis complicated with intra-abdominal infection was 0.840, with a sensitivity of 0.889 and a specificity of 0.721.Conclusion Gram-negative bacteria are the predominant pathogenic bacteria in patients with liver cirrhosis complicated with peritoneal infection. The occurrence of peritoneal infection is associated with the patients' Child-Pugh grade, NLR level and the administration of prophylactic antibiotics, a risk regression equation can thus be established for clinical practice.