Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China.
Curr Med Sci. 2022 Aug;42(4):673-680. doi: 10.1007/s11596-022-2607-3. Epub 2022 Jul 23.
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.
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，增加了短期死亡率的风险。质子泵抑制剂 (PPI) 在 ESLD 患者中经常使用，关于 PPI 治疗在 SBP 发生中的风险存在很大争议，而 PPI 相关 SBP 的发病机制仍不清楚。我们通过 PubMed/MEDLINE 进行了系统的文献检索，主要检索时间为 2000 年 1 月 1 日至 2021 年 1 月 1 日。我们的叙述性综述总结了特定 PPI 治疗对肝硬化患者 SBP 发生和预后的不良影响，描述了 PPI 诱导 SBP 发展的潜在机制，并讨论了与 SBP 发展相关的危险因素以及肝硬化患者 PPI 治疗的策略。尽管关于 PPI 使用与 SBP 发生之间的关联存在争议，但应限制 PPI 的使用仅限于有明确获益指征的患者，对于严重肝损伤的老年患者应谨慎使用。
