标题：肝硬化患者Child-Pugh评分与菌血症发生的相关性

      作者：黄旭明，黄肇权，巫晓华，汪利华，瞿长春
    (云浮市人民医院感染科，广东 云浮 527300)

      卷次： 2015年26卷12期

      【摘要】 目的 分析肝硬化患者菌血症发生与Child-Pugh评分的关系，为肝硬化患者菌血症的早期诊治提
供依据。方法 选取云浮市人民医院2013年1月至2014年12月收治的肝硬化患者97例为研究对象，根据是否
发生菌血症分为菌血症组54例和无菌血症组43例，两组患者均在入院时给予血培养，检查肝功能和凝血酶原时
间，并监测腹水消退及肝性脑病情况，对两组患者的Child-Pugh评分及各指标情况进行单因素分析，对有意义项
进行多因素Logistic回归分析。结果 单因素分析显示，两组患者入院时在肝性脑病分级、凝血酶原时间延长和
腹水发生情况、总胆红素和总蛋白水平以及Child-Pugh评分分布构成情况比较差异均有统计学意义(P<0.05)，对
这些指标进行多因素Logistic分析显示，肝性脑病、腹水、总胆红素≥34 μmol/L、总蛋白水平＜35 g/L和凝血酶原
时间延长>3 s以及Child-Pugh评分C级均为菌血症发生的危险因素。结论 肝硬化患者Child-Pugh评分C级为
菌血症发生的独立危险因素，早期进行Child-Pugh分级并给予早期预防性应用抗生素，能够减少菌血症的发生，
提高菌血症的救治成功率，值得在基层医院推广应用。

      【关键词】 肝硬化；菌血症；Child-Pugh评分

      【中图分类号】 R575.2 【文献标识码】 A 【文章编号】 1003—6350（2015）12—1732—03


Correlation between bacteremia and Child-Pugh scores in patients with liver cirrhosis.
HUANG Xu-ming,
HUANG Zhao-quan, WU Xiao-hua, WANG Li-hua, QU Chang-chun. Department of Infection, Yunfu People's Hospital,
Yunfu 527300, Guangdong, CHINA

【Abstract】 Objective To analyze the relationship between the occurrence of bacteremia and Child-Pugh score
in patients with liver cirrhosis, and to provide basis for early diagnosis and treatment of bacteremia. Methods Nine-
ty-seven patients with liver cirrhosis in Yunfu People's Hospital from January 2013 to December 2014 were enrolled in
the study, which were divided into bacteremia group (54 cases) and non-bacteremia group (43 cases) according to the
occurrence of bacteremia. All the patients were given blood culture, liver function examination, prothrombin time ex-
amination at the time of admission, as well as monitoring of ascites and hepatic encephalopathy situation. Child-Pugh
score and various indicators suffered univariate analysis, and the meaningful items were further analyzed by multivari-
ate logistic regression analysis. Results Univariate analysis showed statistically significant differences in grade of he-
patic encephalopathy, prolonged prothrombin time, occurrence of ascites, total bilirubin, total protein levels, distribu-
tion and composition of Child-Pugh score (P<0.05). Multivariate logistic regression analysis showed that hepatic en-
cephalopathy, ascites, total bilirubin ≥34 μmol/L, total protein <35 g/L, prothrombin time>3 s and Child-Pugh score
of grade C were the risk factors for bacteremia. Conclusion Child-Pugh score of grade C is an independent risk fac-
tor for bacteremia in patients with liver cirrhosis. Early staging of Child-Pugh score and early prophylactic measures
with antibiotics can reduce the incidence of bacteremia and improve the success treatment rate, which is worthy of
clinical application.

      【Key words】 Liver cirrhosis; Bacteremia; Child-Pugh score
基金项目：2013年度广东省卫计委科研基金项目(编号：B2013447)