Mal F, Huu T P, Bendahou M, Trinchet J C, Garnier M, Hakim J, Beaugrand M
Service d'Hépato-Gastroentérologie, Hôpital Jean Verdier, Bondy, France.
J Hepatol. 1991 Jan;12(1):45-9. doi: 10.1016/0168-8278(91)90907-s.
We studied prospectively the ascitic fluid of 47 patients. Thirty-five were cirrhotics (group A) and 12 had malignant peritonitis (group B). All ascitic fluid samples were initially uninfected. We measured opsonic activity by a chemiluminescent assay, and chemoattractant activity by the under agarose technique. We also measured ascitic concentrations of C3, C4, fibronectin, C-reactive protein, immunoglobulins G, A and M and total proteins. All patients were followed throughout the presence of ascites. None of the group B patients developed peritoneal infection, nor did 23 of the group A patients (group A2). Twelve group A patients (group A1) developed spontaneous bacterial peritonitis (SBP), four of them with recurrence. All indices except immunoglobulins A and M were significantly different between group A and group B patients. Comparing group A1 and group A2, only chemoattractant activity and concentrations of total proteins and C3 were significantly lower in group A1. Using a multivariate analysis with Cox's model, only C3 concentration had an independent predictive value for occurrence of SBP in cirrhotic patients.
我们对47例患者的腹水进行了前瞻性研究。35例为肝硬化患者（A组），12例患有恶性腹膜炎（B组）。所有腹水样本最初均未感染。我们通过化学发光测定法测量调理活性，通过琼脂糖下技术测量趋化活性。我们还测量了腹水中C3、C4、纤连蛋白、C反应蛋白、免疫球蛋白G、A和M以及总蛋白的浓度。在腹水存在期间对所有患者进行随访。B组患者均未发生腹膜感染，A组患者中有23例（A2组）也未发生。12例A组患者（A1组）发生了自发性细菌性腹膜炎（SBP），其中4例复发。除免疫球蛋白A和M外，A组和B组患者的所有指标均有显著差异。比较A1组和A2组，A1组仅趋化活性以及总蛋白和C3浓度显著较低。使用Cox模型进行多变量分析时，只有C3浓度对肝硬化患者发生SBP具有独立预测价值。
