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Abstract：
UNASSIGNED: Spontaneous bacterial peritonitis (SBP) remains a major complication of cirrhosis. However, the incidence and the real impact of SBP in determining patient survival rates remain unclear. This study aims to evaluate the incidence and risk factors for SBP development and the role of SBP in predicting transplant-free survival.
UNASSIGNED: Two hundred two consecutive patients underwent 492 paracenteses with biochemical and microbiological analysis of the ascitic fluid. When multiple paracenteses had been performed on a given patient, the first SBP-positive paracentesis or the first paracentesis conducted when none was diagnostic for SBP was included in the study.
UNASSIGNED: SBP was detected in 28 of 202 (13.9%) patients; in 26 of 28 patients, the neutrophil count in the ascitic fluid was ≥250 cells/μl, and in 15 of 28 patients, the cultures were positive. Variables independently associated with SBP were as follows: a higher model of end-stage liver disease (MELD) score, the serum glucose value, elevated CRP serum levels, and higher potassium serum levels. Overall, the median (range) transplant-free survival was 289 (54-1253) days. One hundred (49.5%) patients died, whereas 35 patients (17.3%) underwent liver transplantation. Independent predictors of death or liver transplantation were a higher MELD score and the development of SBP, especially if it was antibiotic-resistant or recurrent SBP.
UNASSIGNED: The occurrence of SBP is associated with more severe liver dysfunction in conjunction with the presence of inflammation. Unlike the occurrence of SBP per se, failure of first-line antibiotic treatment and SBP recurrence appear to strongly influence the mortality rate.
UNASSIGNED: Two hundred two consecutive patients underwent 492 paracenteses with biochemical and microbiological analysis of the ascitic fluid. When multiple paracenteses had been performed on a given patient, the first SBP-positive paracentesis or the first paracentesis conducted when none was diagnostic for SBP was included in the study.
UNASSIGNED: SBP was detected in 28 of 202 (13.9%) patients; in 26 of 28 patients, the neutrophil count in the ascitic fluid was ≥250 cells/μl, and in 15 of 28 patients, the cultures were positive. Variables independently associated with SBP were as follows: a higher model of end-stage liver disease (MELD) score, the serum glucose value, elevated CRP serum levels, and higher potassium serum levels. Overall, the median (range) transplant-free survival was 289 (54-1253) days. One hundred (49.5%) patients died, whereas 35 patients (17.3%) underwent liver transplantation. Independent predictors of death or liver transplantation were a higher MELD score and the development of SBP, especially if it was antibiotic-resistant or recurrent SBP.
UNASSIGNED: The occurrence of SBP is associated with more severe liver dysfunction in conjunction with the presence of inflammation. Unlike the occurrence of SBP per se, failure of first-line antibiotic treatment and SBP recurrence appear to strongly influence the mortality rate.
摘要：
■自发性细菌性腹膜炎（SBP）仍然是肝硬化的主要并发症。然而,SBP在确定患者生存率方面的发生率和真正影响尚不清楚.这项研究旨在评估SBP发展的发生率和危险因素以及SBP在预测无移植生存中的作用。
■两百名连续患者接受了492次腹水生化和微生物学分析。当对给定的患者进行了多个辅助治疗时，本研究纳入了首次SBP阳性穿刺术或无SBP诊断时进行的首次穿刺术.
■在202例患者中的28例（13.9％）中检测到SBP；在28例患者中的26例中，腹水中性粒细胞计数≥250个细胞/μl，在28名患者中，有15名患者，文化是积极的。与SBP独立相关的变量如下：终末期肝病（MELD）评分较高的模型，血清葡萄糖值，血清CRP水平升高，和更高的血清钾水平。总的来说,中位(范围)无移植生存期为289(54-1253)天.一百名(49.5%)病人死亡,而35例患者（17.3％）接受了肝移植。死亡或肝移植的独立预测因素是较高的MELD评分和SBP的发展，特别是如果它是抗生素耐药或复发性SBP。
■SBP的发生与更严重的肝功能障碍以及炎症的存在有关。与SBP本身的发生不同，一线抗生素治疗失败和SBP复发似乎对死亡率有很大影响.
■两百名连续患者接受了492次腹水生化和微生物学分析。当对给定的患者进行了多个辅助治疗时，本研究纳入了首次SBP阳性穿刺术或无SBP诊断时进行的首次穿刺术.
■在202例患者中的28例（13.9％）中检测到SBP；在28例患者中的26例中，腹水中性粒细胞计数≥250个细胞/μl，在28名患者中，有15名患者，文化是积极的。与SBP独立相关的变量如下：终末期肝病（MELD）评分较高的模型，血清葡萄糖值，血清CRP水平升高，和更高的血清钾水平。总的来说,中位(范围)无移植生存期为289(54-1253)天.一百名(49.5%)病人死亡,而35例患者（17.3％）接受了肝移植。死亡或肝移植的独立预测因素是较高的MELD评分和SBP的发展，特别是如果它是抗生素耐药或复发性SBP。
■SBP的发生与更严重的肝功能障碍以及炎症的存在有关。与SBP本身的发生不同，一线抗生素治疗失败和SBP复发似乎对死亡率有很大影响.
