在肝硬化患者中,随着中等性多态核细胞计数增加的死亡率:是时候重新定义护理方法了
Shahid Habib1, Michael Ball2, Chris Thomas2
1Liver Institute PLLC, Tucson, AZ 85716, USA.
概括
使用多态核细胞计数的自发细菌性腹膜炎 (SBP) 诊断可能会错过死亡风险. 中间细胞计数和低性白蛋白表明肝硬化患者的长期死亡率较高.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 自发性细菌性腹膜炎 (SBP) 是一种严重的并发症,发生在非补偿性肝硬化和炎的患者身上.
- 目前的诊断依赖于性流体多态核细胞 (A-PMN) 细胞数≥250个细胞/高功率场 (HPF).
研究的目的:
- 评估A-PMN计数和性流体白蛋白在预测性肝炎患者的死亡率方面的预后价值.
- 确定目前SBP的诊断值是否足够识别患有死亡风险的患者.
主要方法:
- 对117名患有不补偿性肝硬化和的住院患者进行了回顾性队列研究.
- 患者根据A-PMN计数 (≤50,51-249,≥250细胞/HPF),性白细胞计数 (WBC) 和白蛋白水平进行了分层.
- 死亡风险在28日,90日和365天后被评估.
主要成果:
- 患有A-PMN ≤50细胞/HPF的患者28天死亡率最低 (8%).
- 中间A-PMN计数 (51-249细胞/HPF) 与显著更高的90天和365天死亡率有关.
- 低性流体白蛋白 (≤1.0 g/dL) 独立预测增加了365天的死亡率.
结论:
- 标准二进制A-PMN值可能无法完全捕捉SBP中的死亡风险.
- 中间A-PMN数量和低性白蛋白是增加长期死亡率的关键指标.
- 需要更细致的诊断和预后标准来评估SBP在肝硬化患者.
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