Runyon B A
Liver Unit, University of Southern California School of Medicine, Los Angeles, California 90242.
Hepatology. 1988 May-Jun;8(3):632-5. doi: 10.1002/hep.1840080332.
To assess the risk of development of spontaneous bacterial peritonitis in relation to ascitic fluid opsonic activity, routine admission abdominal paracentesis was performed on 119 patients during 141 hospitalizations. Paracentesis was repeated if evidence of peritonitis developed during the hospitalization. The ascitic fluid opsonic activity (0.2 +/- 0.5 log kill) of 24 spontaneously infected specimens was significantly (p less than 0.001) lower than that of the group with sterile portal hypertension-related ascites (0.8 +/- 1.1 log kill), and significantly lower than the group with ascites of miscellaneous type (2.4 +/- 1.0 log kill, p less than 0.001). The C3 and C4 concentrations of the spontaneous peritonitis specimens were also significantly lower than in the specimens from the other groups. Of the 55 patients whose initial sterile ascitic fluid opsonic activity was less than 0.2 log kill, 8 (14.5%) developed spontaneous bacterial peritonitis during the hospitalization; whereas none of the 70 patients with sterile ascitic fluid opsonic activity greater than or equal to 0.2 log kill developed spontaneous peritonitis. This difference in the risk of development of peritonitis was significant (p less than 0.01). Patients with deficient ascitic fluid opsonic activity are predisposed to spontaneous bacterial peritonitis.
为了评估自发性细菌性腹膜炎的发生风险与腹水调理活性之间的关系，在141次住院期间对119例患者进行了常规入院时的腹腔穿刺术。如果住院期间出现腹膜炎证据，则重复进行腹腔穿刺术。24份自发感染标本的腹水调理活性（0.2±0.5对数杀灭率）显著低于（p<0.001）无菌性门静脉高压相关腹水组（0.8±1.1对数杀灭率），且显著低于其他类型腹水组（2.4±1.0对数杀灭率，p<0.001）。自发性腹膜炎标本的C3和C4浓度也显著低于其他组的标本。在初始无菌腹水调理活性低于0.2对数杀灭率的55例患者中，8例（14.5%）在住院期间发生了自发性细菌性腹膜炎；而在70例无菌腹水调理活性大于或等于0.2对数杀灭率的患者中，无1例发生自发性腹膜炎。腹膜炎发生风险的这种差异具有显著性（p<0.01）。腹水调理活性不足的患者易患自发性细菌性腹膜炎。
