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간경변증에 동반된 특발성 세균성 복막염의 재발빈도 및 예견인자

Other Titles
 Frequency and Predictive Factors of Recurrent Spontaneous Bacterial Peritonitis in Cirrhosis 
Authors
 백순구  ;  권상옥  ;  박의련  ;  김준명  ;  이용규  ;  최윤종  ;  김일희  ;  이동기  ;  김일회 
Citation
 Korean Journal of Medicine (대한내과학회지), Vol.54(6) : 795-803, 1998 
Journal Title
 Korean Journal of Medicine (대한내과학회지) 
ISSN
 1226-329X 
Issue Date
1998
Keywords
Recurrent spontaneous bacterial peritonitis ; Frequency ; predictive factor
Abstract
Objectives: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhosis. In the most recently published studies, the prevalence of SBP among hospitalized cirrhotics with ascites has been estimated to be around 10-15%, the mortality rate related to this complication being more than 50%. SBP is thought to appear as a consequence of the impaired defensive mechanisms against infection present in cirrhotic patients, such as depressed reticuloendothelial system phagocytic activity, impaired leukocyte function, reduced serum compliment levels, and low antibacterial activity of ascitic fluid. It has proposed that ascitic fluid opsonin capacity is directly correlated to ascitic protein concentration and that this explains an observed predisposition to infection in patients with low ascitic fluid protein concentration. This present study aims to investigate the frequency of the recurrence of SBP in u large series of cirrhotic patient who recovered from the first episode of SBP and to identify any possible predictors of recurrent SBP. Method: We reviewed records of chart in 312 consecutive cirrhotics with ascites patients treated in our hospital between January, 1988 and August, 1995. Results: The incidence of SRP was 21.8% (68 cases) and showed 80.9% in male, 19.1% in female. Seven- teen (25%) of the 68 patients included in the study after the resolution of their first episode of SBP developed one or more episodes of SBP during follow-up. SBP recurred once in 16 of these patients, twice in 1 patients. The cumulative probability of SBP recurrence was 47.1% at 6 months, 64.7% at 12 months, and 82% at 18 months of follow-up. This study reveals that neither ascitic fluid total protein nor the severity of liver disease(Child's class) predicts the occurence of recurrant SBP. Conclusion: We conclude that the occurrence of recurrent SBP is unrelated to the type of liver disease, and severity of liver disease did not predict the presence of recurrent SBP. Also, ascitic fluid total protein ≤1.0 g/dl, prothrombin time 45% may not be a sensitive predictor of recurrent SBP.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/177229
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