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细菌感染会增加乙肝病毒相关代偿期肝硬化患者失代偿的风险:一项回顾性研究。

Bacterial infection adversely increases the risk of decompensation in patients with hepatitis B virus-related compensated cirrhosis: a retrospective study.

作者信息

Li Yinglun, Niu Bin, Liu Jing, Zhou Hui, Chen Ze, Zhou Yibing, Wei Qian, Jiao Xue, Mi Yuqiang, Li Ping

机构信息

Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China.

Department of Hepatology, Tianjin Second People's Hospital, Tianjin, China.

出版信息

BMC Infect Dis. 2024 Dec 19;24(1):1446. doi: 10.1186/s12879-024-10306-2.

Abstract

BACKGROUND

Hepatitis B virus related compensated cirrhosis generally has a favorable prognosis until decompensation occurs. Bacterial infections are prevalent in Hepatitis B virus related decompensated cirrhosis.Bacterial infection and decompensated hepatitis B cirrhosis are mutually reinforcing. And it also interacts with and promotes certain decompensation-related events. However, the impact of bacterial infections on the progression from compensated to decompensated cirrhosis in Hepatitis B patients remains unclear.

METHODS

We retrospectively analyzed the baseline characteristics of 1,011 patients with Hepatitis B virus related compensated cirrhosis. Using time-dependent regression analysis, we evaluated whether bacterial infections increase the risk of decompensation, defined as the occurrence of ascites, hepatic encephalopathy, or variceal bleeding.

RESULTS

A total of 1,011 patients were retrospectively analyzed over a median follow-up period of 79 months. Bacterial infections were observed in 89 patients (8.8%). Respiratory and urinary tract infections were the most common bacterial infections.Decompensation occurred in 44.9% of patients with bacterial infections, compared to 9% of those without BIs. Patients with bacterial infections had a higher risk of decompensation ([OR] 1.024; 95% CI 1.016-1.032; p < 0.001) than those without bacterial infections.

CONCLUSION

Our findings suggest that bacterial infections have a significant impact on the progression of hepatitis B virus related compensated cirrhosis, notably increasing the risk of decompensation.

摘要

背景

乙肝病毒相关代偿期肝硬化在发生失代偿之前通常预后良好。细菌感染在乙肝病毒相关失代偿期肝硬化中很常见。细菌感染与乙肝失代偿期肝硬化相互促进,还与某些失代偿相关事件相互作用并促进其发生。然而,细菌感染对乙肝患者从代偿期肝硬化进展为失代偿期肝硬化的影响仍不明确。

方法

我们回顾性分析了1011例乙肝病毒相关代偿期肝硬化患者的基线特征。使用时间依赖性回归分析,我们评估了细菌感染是否会增加失代偿的风险,失代偿定义为出现腹水、肝性脑病或静脉曲张出血。

结果

共对1011例患者进行了回顾性分析,中位随访期为79个月。89例患者(8.8%)发生了细菌感染。呼吸道和泌尿系统感染是最常见的细菌感染。细菌感染患者中有44.9%发生了失代偿,而未发生细菌感染的患者中这一比例为9%。与未发生细菌感染的患者相比,发生细菌感染的患者失代偿风险更高([比值比]1.024;95%置信区间1.016 - 1.032;p < 0.001)。

结论

我们的研究结果表明,细菌感染对乙肝病毒相关代偿期肝硬化的进展有显著影响,尤其会增加失代偿的风险。

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