Runyon B A
Gastroenterology. 1986 Dec;91(6):1343-6. doi: 10.1016/0016-5085(86)90185-x.
To assess the risk of development of spontaneous bacterial peritonitis in relation to the ascitic fluid total protein concentration, routine admission abdominal paracentesis was performed on a group of 107 patients during 125 hospitalizations. The paracentesis was repeated if evidence of peritonitis developed during hospitalization. Twenty-one episodes of spontaneous peritonitis (or its culture-negative variant) were documented in 17 patients. The ascitic fluid protein concentration in the spontaneous peritonitis group (0.72 +/- 0.53 g/dl) was significantly lower (p less than 0.001) than that in the group of patients with sterile portal hypertension-related ascites (1.36 +/- 0.89 g/dl) and was significantly lower than that of patients with ascites due to miscellaneous causes. Of the patients whose initial sterile ascitic fluid protein concentration was less than or equal to 1.0 g/dl, 7 of 47 (15%) developed spontaneous peritonitis during their hospitalization; whereas only 1 of 65 (1.5%) patients who had an initial sterile ascitic fluid protein concentration greater than 1.0 g/dl developed spontaneous peritonitis. This difference in risk of development of peritonitis in relation to initial ascitic fluid protein concentration was also significant (p less than 0.01). Low-protein-concentration ascitic fluid predisposes to spontaneous bacterial peritonitis.
为评估自发性细菌性腹膜炎的发生风险与腹水总蛋白浓度的关系，在125次住院期间，对一组107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。17例患者记录到21次自发性腹膜炎发作（或其培养阴性变体）。自发性腹膜炎组的腹水蛋白浓度（0.72±0.53g/dl）显著低于无菌性门静脉高压相关腹水组（1.36±0.89g/dl）（p<0.001），且显著低于其他原因所致腹水患者。初始无菌腹水蛋白浓度小于或等于1.0g/dl的患者中，47例中有7例（15%）在住院期间发生自发性腹膜炎；而初始无菌腹水蛋白浓度大于1.0g/dl的65例患者中只有1例（1.5%）发生自发性腹膜炎。与初始腹水蛋白浓度相关的腹膜炎发生风险差异也具有显著性（p<0.01）。低蛋白浓度腹水易引发自发性细菌性腹膜炎。
