Abstract：
Spontaneous bacterial peritonitis (SBP) is one of the most common complications in patients with end-stage liver disease (ESLD), which increases the risk of short-term mortality. Proton pump inhibitors (PPIs) are frequently used in patients with ESLD, in which controversies about the risk of PPI treatment in the occurrence of SBP are largely raised and the pathogenic mechanism of PPI-associated SBP remains unclear. We conducted a systematic literature search through PubMed/MEDLINE for publications mainly from 1 January 2000 to 1 January 2021. Our narrative review summarized the adverse effect of specific PPI therapy on the occurrence and prognosis of SBP in cirrhotic patients, described the potential mechanisms by which PPI induces the development of SBP, and discussed the risk factors associated with the development of SBP and the strategy of PPI therapy in cirrhotic patients. Although controversy regarding the association between PPI use and the occurrence of SBP exists, PPIs use should be restricted to patients with clear benefit indications, and be cautious for elderly patients with severe liver damage.
摘要：
自发性细菌性腹膜炎（SBP）是终末期肝病（ESLD）患者最常见的并发症之一，这增加了短期死亡的风险。质子泵抑制剂（PPI）经常用于ESLD患者，其中关于PPI治疗在SBP发生中的风险的争议在很大程度上增加，PPI相关SBP的致病机制尚不清楚。我们通过PubMed/MEDLINE对主要从2000年1月1日至2021年1月1日的出版物进行了系统的文献检索。我们的叙述回顾总结了特异性PPI治疗对肝硬化患者SBP的发生和预后的不利影响。描述了PPI诱导SBP发展的潜在机制，并讨论了与肝硬化患者SBP发展相关的危险因素和PPI治疗策略。尽管关于PPI使用与SBP发生之间的关联存在争议，PPI的使用应仅限于有明确获益指征的患者，对于严重肝损害的老年患者要谨慎。
