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Article(id=1203061225883148317, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1203061212524290053, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2023.01.0001, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1655136000000, receivedDateStr=2022-06-14, revisedDate=null, revisedDateStr=null, acceptedDate=1658505600000, acceptedDateStr=2022-07-23, onlineDate=1764761748047, onlineDateStr=2025-12-03, pubDate=1674835200000, pubDateStr=2023-01-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1764761748047, onlineIssueDateStr=2025-12-03, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1764761748047, creator=13701087609, updateTime=1764761748047, updator=13701087609, issue=Issue{id=1203061212524290053, tenantId=1146029695717560320, journalId=1189873630562394117, year='2023', volume='48', issue='1', pageStart='1', pageEnd='120', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1764761744816, creator=13701087609, updateTime=1764763211166, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1203067362732913657, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1203061212524290053, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1203067362732913658, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1203061212524290053, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1, endPage=6, ext={EN=ArticleExt(id=1203061227179188274, articleId=1203061225883148317, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Treatment strategies of bacterial infection in liver cirrhosis, columnId=1203061223249125389, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Evaluation and Management of Cirrhosis and Its Complications, runingTitle=null, highlight=null, articleAbstract=

Infection is a common complication and leading cause of death in liver cirrhosis patients. In recent years, people gradually recognize the vital impact of infection, especially spontaneous bacterial peritonitis, on the course and prognosis of liver cirrhosis patients. Timely and effective empiric antibiotic therapy is particularly critical for the treatment of liver cirrhosis patients with bacterial infection. However, due to the spread of multidrug resistant bacteria and extensively drug-resistant bacteria, infection in cirrhosis has also become a difficult problem. At the same time, we have a clearer understanding on the pathogenesis of infection in cirrhosis. Novel therapeutic methods, such as intestinal microecological intervention and immunoregulatory therapy, have also become research hotspots recently. Establishing an effective treatment plan for liver cirrhosis patients with bacterial infections is the key to improve the survival rate and quality of life of these patients.

, correspAuthors=Chang-Qing Yang, authorNote=null, correspAuthorsNote=
E-mail:
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感染是肝硬化患者的常见并发症及主要死亡原因。近年来，人们逐渐认识到感染，尤其是自发性腹膜炎对肝硬化患者病程及预后有重要影响。及时有效的经验性抗感染治疗对肝硬化合并感染患者的治疗尤为关键，但由于多重耐药菌及广泛耐药菌的传播，肝硬化合并感染的治疗成为难点。随着研究的不断深入，肝硬化合并感染的发病机制逐渐明确，肠道微生态干预及免疫调节治疗等新型治疗手段已成为热点。为肝硬化合并感染患者制定有效的治疗方案是提高肝硬化患者生存率及生活质量的关键。

, correspAuthors=杨长青, authorNote=null, correspAuthorsNote=
杨长青，E-mail：
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王芷婧，硕士研究生，主要从事非酒精性脂肪性肝病和肝纤维化等肝脏疾病的基础研究

杨长青，二级教授，主任医师，博士生导师，中国老年医学学会理事兼消化分会副会长，上海医学会肝病分会候任主任委员，上海中西医结合学会消化分会主任委员，上海领军人才，上海市优秀学科带头人。

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王芷婧，硕士研究生，主要从事非酒精性脂肪性肝病和肝纤维化等肝脏疾病的基础研究

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王芷婧，硕士研究生，主要从事非酒精性脂肪性肝病和肝纤维化等肝脏疾病的基础研究

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杨长青，二级教授，主任医师，博士生导师，中国老年医学学会理事兼消化分会副会长，上海医学会肝病分会候任主任委员，上海中西医结合学会消化分会主任委员，上海领军人才，上海市优秀学科带头人。

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杨长青，二级教授，主任医师，博士生导师，中国老年医学学会理事兼消化分会副会长，上海医学会肝病分会候任主任委员，上海中西医结合学会消化分会主任委员，上海领军人才，上海市优秀学科带头人。

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Research progress of intestinal flora and hepatic encephalopathy[J]. Med J Chin PLA, 2021, 46(9): 860-864., articleTitle=Research progress of intestinal flora and hepatic encephalopathy, refAbstract=null), Reference(id=1203061234573746460, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=46, issue=9, pageStart=860, pageEnd=864, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=李变玲, 黄会芳, 王晓阳, journalName=解放军医学杂志, refType=null, unstructuredReference=[李变玲, 黄会芳, 王晓阳, 等. 肠道菌群与肝性脑病的关系及其治疗措施研究进展[J]. 解放军医学杂志, 2021, 46(9): 860-864.], articleTitle=肠道菌群与肝性脑病的关系及其治疗措施研究进展, refAbstract=null), Reference(id=1203061234707964197, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2010, volume=139, issue=4, pageStart=1246, pageEnd=1256.e5, url=null, language=null, rfNumber=[2], rfOrder=2, authorNames=Arvaniti V, D'Amico G, Fede G, journalName=Gastroenterology, refType=null, unstructuredReference=Arvaniti V, D'Amico G, Fede G, et al. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis[J]. Gastroenterology, 2010, 139(4): 1246-1256.e5., articleTitle=Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis, refAbstract=null), Reference(id=1203061234850570537, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=70, issue=3, pageStart=531, pageEnd=536, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=Bajaj JS, Garcia-Tsao G, Biggins SW, journalName=Gut, refType=null, unstructuredReference=Bajaj JS, Garcia-Tsao G, Biggins SW, et al. Comparison of mortality risk in patients with cirrhosis and COVID-19 compared with patients with cirrhosis alone and COVID-19 alone: multicentre matched cohort[J]. Gut, 2021, 70(3): 531-536., articleTitle=Comparison of mortality risk in patients with cirrhosis and COVID-19 compared with patients with cirrhosis alone and COVID-19 alone: multicentre matched cohort, refAbstract=null), Reference(id=1203061234942845230, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=156, issue=5, pageStart=1368, pageEnd=1380.e10, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Piano S, Singh V, Caraceni P, journalName=Gastroenterology, refType=null, unstructuredReference=Piano S, Singh V, Caraceni P, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide[J]. Gastroenterology, 2019, 156(5): 1368-1380.e10., articleTitle=Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide, refAbstract=null), Reference(id=1203061235014148404, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=8, issue=6, pageStart=307, pageEnd=321, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D, journalName=World J Hepatol, refType=null, unstructuredReference=Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D. Bacterial infections in cirrhosis: a critical review and practical guidance[J]. World J Hepatol, 2016, 8(6): 307-321., articleTitle=Bacterial infections in cirrhosis: a critical review and practical guidance, refAbstract=null), Reference(id=1203061235123200314, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=65, issue=5, pageStart=1043, pageEnd=1054, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=Fernández J, Bert F, Nicolas-Chanoine MH, journalName=J Hepatol, refType=null, unstructuredReference=Fernández J, Bert F, Nicolas-Chanoine MH. The challenges of multi-drug-resistance in hepatology[J]. J Hepatol, 2016, 65(5): 1043-1054., articleTitle=The challenges of multi-drug-resistance in hepatology, refAbstract=null), Reference(id=1203061235265806655, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2017, volume=7, issue=null, pageStart=46025, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Shi L, Wu D, Wei L, journalName=Sci Rep, refType=null, unstructuredReference=Shi L, Wu D, Wei L, et al. Nosocomial and community-acquired spontaneous bacterial peritonitis in patients with liver cirrhosis in China:comparative microbiology and therapeutic implications[J]. Sci Rep, 2017, 7: 46025., articleTitle=Nosocomial and community-acquired spontaneous bacterial peritonitis in patients with liver cirrhosis in China:comparative microbiology and therapeutic implications, refAbstract=null), Reference(id=1203061235358081349, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2009, volume=48, issue=9, pageStart=1230, pageEnd=1236, url=null, language=null, rfNumber=[8], rfOrder=8, authorNames=Cheong HS, Kang CI, Lee JA, journalName=Clin Infect Dis, refType=null, unstructuredReference=Cheong HS, Kang CI, Lee JA, et al. Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis[J]. Clin Infect Dis, 2009, 48(9): 1230-1236., articleTitle=Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis, refAbstract=null), Reference(id=1203061235446161736, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2018, volume=69, issue=2, pageStart=406, pageEnd=460, url=null, language=null, rfNumber=[9], rfOrder=9, authorNames=European Association for the Study of the Liver, journalName=J Hepatol, refType=null, unstructuredReference=European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69(2): 406-460., articleTitle=EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis, refAbstract=null), Reference(id=1203061235551019342, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=51, issue=9, pageStart=1300, pageEnd=1307, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Wieser A, Li HW, Zhang J, journalName=Dig Liver Dis, refType=null, unstructuredReference=Wieser A, Li HW, Zhang J, et al. Evaluating the best empirical antibiotic therapy in patients with acute-on-chronic liver failure and spontaneous bacterial peritonitis[J]. Dig Liver Dis, 2019, 51(9): 1300-1307., articleTitle=Evaluating the best empirical antibiotic therapy in patients with acute-on-chronic liver failure and spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061235668459860, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2017, volume=47, issue=1, pageStart=44, pageEnd=52, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=Lutz P, Nischalke HD, Krämer B, journalName=Eur J Clin Investig, refType=null, unstructuredReference=Lutz P, Nischalke HD, Krämer B, et al. Antibiotic resistance in healthcare-related and nosocomial spontaneous bacterial peritonitis[J]. Eur J Clin Investig, 2017, 47(1): 44-52., articleTitle=Antibiotic resistance in healthcare-related and nosocomial spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061235764928857, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=1, pageStart=3285, pageEnd=null, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=Griemsmann M, Tergast TL, Simon N, journalName=Sci Rep, refType=null, unstructuredReference=Griemsmann M, Tergast TL, Simon N, et al. Nosocomial infections in female compared with male patients with decompensated liver cirrhosis[J]. Sci Rep, 2022, 12(1): 3285., articleTitle=Nosocomial infections in female compared with male patients with decompensated liver cirrhosis, refAbstract=null), Reference(id=1203061235861397855, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2013, volume=33, issue=2, pageStart=220, pageEnd=230, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=Reuken PA, Stallmach A, Bruns T, journalName=Liver Int, refType=null, unstructuredReference=Reuken PA, Stallmach A, Bruns T. Mortality after urinary tract infections in patients with advanced cirrhosis - Relevance of acute kidney injury and comorbidities[J]. Liver Int, 2013, 33(2): 220-230., articleTitle=Mortality after urinary tract infections in patients with advanced cirrhosis - Relevance of acute kidney injury and comorbidities, refAbstract=null), Reference(id=1203061235949478244, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=384, issue=24, pageStart=2317, pageEnd=2330, url=null, language=null, rfNumber=[14], rfOrder=14, authorNames=Bajaj JS, Kamath PS, Reddy KR, journalName=N Engl J Med, refType=null, unstructuredReference=Bajaj JS, Kamath PS, Reddy KR. The evolving challenge of infections in cirrhosis[J]. N Engl J Med, 2021, 384(24): 2317-2330., articleTitle=The evolving challenge of infections in cirrhosis, refAbstract=null), Reference(id=1203061236087890282, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2017, volume=62, issue=2, pageStart=345, pageEnd=356, url=null, language=null, rfNumber=[15], rfOrder=15, authorNames=Piotrowski D, Boroń-Kaczmarska A, journalName=Adv Med Sci, refType=null, unstructuredReference=Piotrowski D, Boroń-Kaczmarska A. Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment[J]. Adv Med Sci, 2017, 62(2): 345-356., articleTitle=Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment, refAbstract=null), Reference(id=1203061236205330797, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2014, volume=23, issue=null, pageStart=69, pageEnd=74, url=null, language=null, rfNumber=[16], rfOrder=16, authorNames=Hassan EA, El-Rehim ASA, Hassany SM, journalName=Int J Infect Dis, refType=null, unstructuredReference=Hassan EA, El-Rehim ASA, Hassany SM, et al. Fungal infection in patients with end-stage liver disease: low frequency or low index of suspicion[J]. Int J Infect Dis, 2014, 23: 69-74., articleTitle=Fungal infection in patients with end-stage liver disease: low frequency or low index of suspicion, refAbstract=null), Reference(id=1203061236289216882, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2018, volume=26, issue=1, pageStart=13, pageEnd=16, url=null, language=null, rfNumber=[17], rfOrder=17, authorNames=Zhang L, Liu ZY, journalName=Chin J Hepatol, refType=null, unstructuredReference=Zhang L, Liu ZY. End-stage liver disease and invasive fungal infection[J]. Chin J Hepatol, 2018, 26(1): 13-16., articleTitle=End-stage liver disease and invasive fungal infection, refAbstract=null), Reference(id=1203061236389880183, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2018, volume=26, issue=1, pageStart=13, pageEnd=16, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=张黎, 刘正印, journalName=中华肝脏病杂志, refType=null, unstructuredReference=[张黎, 刘正印. 终末期肝病与侵袭性真菌感染[J]. 中华肝脏病杂志, 2018, 26(1): 13-16.], articleTitle=终末期肝病与侵袭性真菌感染, refAbstract=null), Reference(id=1203061236482154876, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=72, issue=3, pageStart=558, pageEnd=577, url=null, language=null, rfNumber=[18], rfOrder=19, authorNames=Albillos A, de Gottardi A, Rescigno M, journalName=J Hepatol, refType=null, unstructuredReference=Albillos A, de Gottardi A, Rescigno M. The gut-liver axis in liver disease: Pathophysiological basis for therapy[J]. J Hepatol, 2020, 72(3): 558-577., articleTitle=The gut-liver axis in liver disease: Pathophysiological basis for therapy, refAbstract=null), Reference(id=1203061236607984001, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=13, issue=4, pageStart=241, pageEnd=256, url=null, language=null, rfNumber=[19], rfOrder=20, authorNames=Chinese Society of Microecology, Chinese Preventive Medicine Association, journalName=Chin J Clin Infect Dis, refType=null, unstructuredReference=Chinese Society of Microecology, Chinese Preventive Medicine Association. Chinese expert consensus on clinical application of microecological agents (2020 version)[J]. Chin J Clin Infect Dis, 2020, 13(4): 241-256., articleTitle=Chinese expert consensus on clinical application of microecological agents (2020 version), refAbstract=null), Reference(id=1203061236721230215, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=13, issue=4, pageStart=241, pageEnd=256, url=null, language=null, rfNumber=[19], rfOrder=21, authorNames=中华预防医学会微生态学分会, journalName=中华临床感染病杂志, refType=null, unstructuredReference=[中华预防医学会微生态学分会. 中国微生态调节剂临床应用专家共识 (2020版)[J]. 中华临床感染病杂志, 2020, 13(4): 241-256.], articleTitle=中国微生态调节剂临床应用专家共识 (2020版), refAbstract=null), Reference(id=1203061237862080909, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2002, volume=36, issue=4, pageStart=501, pageEnd=506, url=null, language=null, rfNumber=[20], rfOrder=22, authorNames=Bauer TM, Fernández J, Navasa M, journalName=J Hepatol, refType=null, unstructuredReference=Bauer TM, Fernández J, Navasa M, et al. Failure of Lactobacillus spp. to prevent bacterial translocation in a rat model of experimental cirrhosis[J]. J Hepatol, 2002, 36(4): 501-506., articleTitle=Failure of Lactobacillus spp. to prevent bacterial translocation in a rat model of experimental cirrhosis, refAbstract=null), Reference(id=1203061237966938512, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2012, volume=24, issue=7, pageStart=831, pageEnd=839, url=null, language=null, rfNumber=[21], rfOrder=23, authorNames=Pande C, Kumar A, Sarin SK, journalName=Eur J Gastroenterol Hepatol, refType=null, unstructuredReference=Pande C, Kumar A, Sarin SK. Addition of probiotics to norfloxacin does not improve efficacy in the prevention of spontaneous bacterial peritonitis: a double-blind placebo-controlled randomized-controlled trial[J]. Eur J Gastroenterol Hepatol, 2012, 24(7): 831-839., articleTitle=Addition of probiotics to norfloxacin does not improve efficacy in the prevention of spontaneous bacterial peritonitis: a double-blind placebo-controlled randomized-controlled trial, refAbstract=null), Reference(id=1203061238164070806, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=28, issue=12, pageStart=1450, pageEnd=1454, url=null, language=null, rfNumber=[22], rfOrder=24, authorNames=Elfert A, Abo Ali L, Soliman S, journalName=Eur J Gastroenterol Hepatol, refType=null, unstructuredReference=Elfert A, Abo Ali L, Soliman S, et al. Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis[J]. Eur J Gastroenterol Hepatol, 2016, 28(12): 1450-1454., articleTitle=Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061238508003743, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2011, volume=101, issue=2, pageStart=131, pageEnd=137, url=null, language=null, rfNumber=[23], rfOrder=25, authorNames=Aubin E, Roberge C, Lemieux R, journalName=Vox Sang, refType=null, unstructuredReference=Aubin E, Roberge C, Lemieux R, et al. Immunomodulatory effects of therapeutic preparations of human albumin[J]. Vox Sang, 2011, 101(2):131-137., articleTitle=Immunomodulatory effects of therapeutic preparations of human albumin, refAbstract=null), Reference(id=1203061238612861346, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2005, volume=42, issue=3, pageStart=627, pageEnd=634, url=null, language=null, rfNumber=[24], rfOrder=26, authorNames=Fernández J, Monteagudo J, Bargallo X, journalName=Hepatology, refType=null, unstructuredReference=Fernández J, Monteagudo J, Bargallo X, et al. A randomized unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis[J]. Hepatology, 2005, 42(3): 627-634., articleTitle=A randomized unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061238789022120, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2004, volume=41, issue=3, pageStart=384, pageEnd=390, url=null, language=null, rfNumber=[25], rfOrder=27, authorNames=Fernández J, Navasa M, Garcia-Pagan JC, journalName=J Hepatol, refType=null, unstructuredReference=Fernández J, Navasa M, Garcia-Pagan JC, et al. Effect of intravenous albumin on systemic and hepatic hemodynamics and vasoactive neurohormonal systems in patients with cirrhosis and spontaneous bacterial peritonitis[J]. J Hepatol, 2004, 41(3): 384-390., articleTitle=Effect of intravenous albumin on systemic and hepatic hemodynamics and vasoactive neurohormonal systems in patients with cirrhosis and spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061238940017070, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2013, volume=11, issue=2, pageStart=123, pageEnd=130.e1, url=null, language=null, rfNumber=[26], rfOrder=28, authorNames=Salerno F, Navickis RJ, Wilkes MM, journalName=Clin Gastroenterol Hepatol, refType=null, unstructuredReference=Salerno F, Navickis RJ, Wilkes MM. Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials[J]. Clin Gastroenterol Hepatol, 2013, 11(2): 123-130.e1., articleTitle=Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials, refAbstract=null), Reference(id=1203061239103594934, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2018, volume=16, issue=12, pageStart=10, pageEnd=16, url=null, language=null, rfNumber=[27], rfOrder=29, authorNames=Li HB, Men P, Wang Y, journalName=Clin Med J, refType=null, unstructuredReference=Li HB, Men P, Wang Y, et al. Expert consensus on rapid advice guidelines for the pharmacological management of human albumin in patients with liver cirrhosis[J]. Clin Med J, 2018, 16(12): 10-16., articleTitle=Expert consensus on rapid advice guidelines for the pharmacological management of human albumin in patients with liver cirrhosis, refAbstract=null), Reference(id=1203061239204258236, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2018, volume=16, issue=12, pageStart=10, pageEnd=16, url=null, language=null, rfNumber=[27], rfOrder=30, authorNames=李慧博, 门鹏, 王宇, journalName=临床药物治疗杂志, refType=null, unstructuredReference=[李慧博, 门鹏, 王宇, 等. 《人血白蛋白用于肝硬化治疗的快速建议指南》解读[J]. 临床药物治疗杂志, 2018, 16(12): 10-16.], articleTitle=《人血白蛋白用于肝硬化治疗的快速建议指南》解读, refAbstract=null), Reference(id=1203061239296532927, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2012, volume=10, issue=3, pageStart=309, pageEnd=315, url=null, language=null, rfNumber=[28], rfOrder=31, authorNames=Poca M, Concepción M, Casas M, journalName=Clin Gastroenterol Hepatol, refType=null, unstructuredReference=Poca M, Concepción M, Casas M, et al. Role of albumin treatment in patients with spontaneous bacterial peritonitis[J]. Clin Gastroenterol Hepatol, 2012, 10(3): 309-315., articleTitle=Role of albumin treatment in patients with spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061239388807621, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2012, volume=57, issue=4, pageStart=759, pageEnd=765, url=null, language=null, rfNumber=[29], rfOrder=32, authorNames=Guevara M, Terra C, Nazar A, journalName=J Hepatol, refType=null, unstructuredReference=Guevara M, Terra C, Nazar A, et al. Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study[J]. J Hepatol, 2012, 57(4): 759-765., articleTitle=Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study, refAbstract=null), Reference(id=1203061239527219655, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=18, issue=4, pageStart=963, pageEnd=973.e14, url=null, language=null, rfNumber=[30], rfOrder=33, authorNames=Fernández J, Angeli P, Trebicka J, journalName=Clin Gastroenterol Hepatol, refType=null, unstructuredReference=Fernández J, Angeli P, Trebicka J, et al. Efficacy of albumin treatment for patients with cirrhosis and infections unrelated to spontaneous bacterial peritonitis[J]. Clin Gastroenterol Hepatol, 2020, 18(4): 963-973.e14., articleTitle=Efficacy of albumin treatment for patients with cirrhosis and infections unrelated to spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061239753712079, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=384, issue=9, pageStart=808, pageEnd=817, url=null, language=null, rfNumber=[31], rfOrder=34, authorNames=China L, Freemantle N, Forrest E, journalName=N Engl J Med, refType=null, unstructuredReference=China L, Freemantle N, Forrest E, et al. A randomized trial of albumin infusions in hospitalized patients with cirrhosis[J]. N Engl J Med, 2021, 384(9): 808-817., articleTitle=A randomized trial of albumin infusions in hospitalized patients with cirrhosis, refAbstract=null), Reference(id=1203061239900512724, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2015, volume=62, issue=4, pageStart=822, pageEnd=830, url=null, language=null, rfNumber=[32], rfOrder=35, authorNames=Thévenot T, Bureau C, Oberti F, journalName=J Hepatol, refType=null, unstructuredReference=Thévenot T, Bureau C, Oberti F, et al. Effect of albumin in cirrhotic patients with infection other than spontaneous bacterial peritonitis. A randomized trial[J]. J Hepatol, 2015, 62(4): 822-830., articleTitle=Effect of albumin in cirrhotic patients with infection other than spontaneous bacterial peritonitis. A randomized trial, refAbstract=null), Reference(id=1203061240009564633, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=52, issue=10, pageStart=1137, pageEnd=1142, url=null, language=null, rfNumber=[33], rfOrder=36, authorNames=Wong YJ, Qiu TY, Tam YC, journalName=Dig Liver Dis, refType=null, unstructuredReference=Wong YJ, Qiu TY, Tam YC, et al. Efficacy and safety of IV albumin for non-spontaneous bacterial peritonitis infection among patients with cirrhosis: a systematic review and meta-analysis[J]. Dig Liver Dis, 2020, 52(10): 1137-1142., articleTitle=Efficacy and safety of IV albumin for non-spontaneous bacterial peritonitis infection among patients with cirrhosis: a systematic review and meta-analysis, refAbstract=null), Reference(id=1203061240127005152, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=1, pageStart=1, pageEnd=9, url=null, language=null, rfNumber=[34], rfOrder=37, authorNames=Liver Failure and Artificial Liver Group, Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Society of Hepatology, Chinese Medical Association, journalName=Chin J Infect, refType=null, unstructuredReference=Liver Failure and Artificial Liver Group, Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure (2018)[J]. Chin J Infect, 2019, 37(1): 1-9., articleTitle=Guideline for diagnosis and treatment of liver failure (2018), refAbstract=null), Reference(id=1203061240206696933, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=1, pageStart=1, pageEnd=9, url=null, language=null, rfNumber=[34], rfOrder=38, authorNames=中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组, journalName=中华传染病杂志, refType=null, unstructuredReference=[中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南 (2018年版) [J]. 中华传染病杂志, 2019, 37(1): 1-9.], articleTitle=肝衰竭诊治指南 (2018年版), refAbstract=null), Reference(id=1203061240315748843, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2022, volume=16, issue=4, pageStart=775, pageEnd=788, url=null, language=null, rfNumber=[35], rfOrder=39, authorNames=Chen JF, Chen SR, Lei ZY, journalName=Hepatol Int, refType=null, unstructuredReference=Chen JF, Chen SR, Lei ZY, et al. Safety and efficacy of Thymosin α1 in the treatment of hepatitis B virus-related acute-on-chronic liver failure:a randomized controlled trial[J]. Hepatol Int, 2022, 16(4): 775-788., articleTitle=Safety and efficacy of Thymosin α1 in the treatment of hepatitis B virus-related acute-on-chronic liver failure:a randomized controlled trial, refAbstract=null), Reference(id=1203061240470938098, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=26, issue=21, pageStart=4897, pageEnd=4899, url=null, language=null, rfNumber=[36], rfOrder=40, authorNames=Chen M, Zhu J, Yuan YL, journalName=Chin J Nosocomiol, refType=null, unstructuredReference=Chen M, Zhu J, Yuan YL, et al. Clinical effect of human immunoglobulin combined with antibiotic therapy in patients with advanced liver infection[J]. Chin J Nosocomiol, 2016, 26(21): 4897-4899., articleTitle=Clinical effect of human immunoglobulin combined with antibiotic therapy in patients with advanced liver infection, refAbstract=null), Reference(id=1203061240563212791, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=26, issue=21, pageStart=4897, pageEnd=4899, url=null, language=null, rfNumber=[36], rfOrder=41, authorNames=陈敏, 朱俊, 袁玉林, journalName=中华医院感染学杂志, refType=null, unstructuredReference=[陈敏, 朱俊, 袁玉林, 等. 人免疫球蛋白联合抗菌药物治疗中晚期肝病感染患者的临床效果研究[J]. 中华医院感染学杂志, 2016, 26(21): 4897-4899.], articleTitle=人免疫球蛋白联合抗菌药物治疗中晚期肝病感染患者的临床效果研究, refAbstract=null), Reference(id=1203061240668070395, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=12, issue=null, pageStart=2839, pageEnd=2851, url=null, language=null, rfNumber=[37], rfOrder=42, authorNames=Luu S, Spelman D, Woolley IJ, journalName=Infect Drug Resist, refType=null, unstructuredReference=Luu S, Spelman D, Woolley IJ. Post-splenectomy sepsis: preventative strategies, challenges, and solutions[J]. Infect Drug Resist, 2019, 12:2839-2851., articleTitle=Post-splenectomy sepsis: preventative strategies, challenges, and solutions, refAbstract=null), Reference(id=1203061240781316608, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2013, volume=41, issue=8, pageStart=e163, pageEnd=e170, url=null, language=null, rfNumber=[38], rfOrder=43, authorNames=Nakamura K, Doi K, Okamoto K, journalName=Crit Care Med, refType=null, unstructuredReference=Nakamura K, Doi K, Okamoto K, et al. Specific antibody in Ⅳ immunoglobulin for postsplenectomy sepsis[J]. Crit Care Med, 2013, 41(8):e163-e170., articleTitle=Specific antibody in Ⅳ immunoglobulin for postsplenectomy sepsis, refAbstract=null), Reference(id=1203061240886174212, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=13, issue=1, pageStart=44, pageEnd=51, url=null, language=null, rfNumber=[39], rfOrder=44, authorNames=Nakamura K, Takahashi Y, Sonoo T, journalName=J Glob Infect Dis, refType=null, unstructuredReference=Nakamura K, Takahashi Y, Sonoo T, et al. Intravenous immunoglobulin for overwhelming postsplenectomy infection[J]. J Glob Infect Dis, 2021, 13(1): 44-51., articleTitle=Intravenous immunoglobulin for overwhelming postsplenectomy infection, refAbstract=null), Reference(id=1203061241012003334, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=1, issue=null, pageStart=CD013125, pageEnd=null, url=null, language=null, rfNumber=[40], rfOrder=45, authorNames=Komolafe O, Roberts D, Freeman SC, journalName=Cochrane Database Syst Rev, refType=null, unstructuredReference=Komolafe O, Roberts D, Freeman SC, et al. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis[J]. Cochrane Database Syst Rev, 2020, 1: CD013125., articleTitle=Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis, refAbstract=null), Reference(id=1203061241104278026, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=13, issue=8, pageStart=751, pageEnd=759, url=null, language=null, rfNumber=[41], rfOrder=46, authorNames=Facciorusso A, Antonino M, Orsitto E, journalName=Expert Rev Gastroenterol Hepatol, refType=null, unstructuredReference=Facciorusso A, Antonino M, Orsitto E, et al. Primary and secondary prophylaxis of spontaneous bacterial peritonitis: current state of the art[J]. Expert Rev Gastroenterol Hepatol, 2019, 13(8): 751-759., articleTitle=Primary and secondary prophylaxis of spontaneous bacterial peritonitis: current state of the art, refAbstract=null), Reference(id=1203061241213329935, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2016, volume=63, issue=6, pageStart=2019, pageEnd=2031, url=null, language=null, rfNumber=[42], rfOrder=47, authorNames=Fernández J, Tandon P, Mensa J, journalName=Hepatology, refType=null, unstructuredReference=Fernández J, Tandon P, Mensa J, et al. Antibiotic prophylaxis in cirrhosis: good and bad[J]. Hepatology, 2016, 63(6): 2019-2031., articleTitle=Antibiotic prophylaxis in cirrhosis: good and bad, refAbstract=null), Reference(id=1203061242358374932, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2020, volume=11, issue=8, pageStart=e00223, pageEnd=null, url=null, language=null, rfNumber=[43], rfOrder=48, authorNames=Mücke MM, Mücke VT, Graf C, journalName=Clin Transl Gastroenterol, refType=null, unstructuredReference=Mücke MM, Mücke VT, Graf C, et al. Efficacy of norfloxacin prophylaxis to prevent spontaneous bacterial peritonitis: a systematic review and Meta-analysis[J]. Clin Transl Gastroenterol, 2020, 11(8): e00223., articleTitle=Efficacy of norfloxacin prophylaxis to prevent spontaneous bacterial peritonitis: a systematic review and Meta-analysis, refAbstract=null), Reference(id=1203061242442261014, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=84, issue=2, pageStart=333, pageEnd=342, url=null, language=null, rfNumber=[44], rfOrder=49, authorNames=Pimentel R, Gregório C, Figueiredo P, journalName=Acta Gastroenterol Belg, refType=null, unstructuredReference=Pimentel R, Gregório C, Figueiredo P. Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in liver cirrhosis: systematic review[J]. Acta Gastroenterol Belg, 2021, 84(2): 333-342., articleTitle=Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in liver cirrhosis: systematic review, refAbstract=null), Reference(id=1203061242593255963, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=15, issue=1, pageStart=155, pageEnd=165, url=null, language=null, rfNumber=[45], rfOrder=50, authorNames=Zeng X, Sheng X, Wang PQ, journalName=Hepatol Int, refType=null, unstructuredReference=Zeng X, Sheng X, Wang PQ, et al. Low-dose rifaximin prevents complications and improves survival in patients with decompensated liver cirrhosis[J]. Hepatol Int, 2021, 15(1): 155-165., articleTitle=Low-dose rifaximin prevents complications and improves survival in patients with decompensated liver cirrhosis, refAbstract=null), Reference(id=1203061242702307869, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2019, volume=70, issue=9, pageStart=1916, pageEnd=1924, url=null, language=null, rfNumber=[46], rfOrder=51, authorNames=Mücke MM, Mayer A, Kessel J, journalName=Clin Infect Dis, refType=null, unstructuredReference=Mücke MM, Mayer A, Kessel J, et al. Quinolone and multidrug resistance predicts failure of antibiotic prophylaxis of spontaneous bacterial peritonitis[J]. Clin Infect Dis, 2019, 70(9): 1916-1924., articleTitle=Quinolone and multidrug resistance predicts failure of antibiotic prophylaxis of spontaneous bacterial peritonitis, refAbstract=null), Reference(id=1203061242832331297, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1203061225883148317, doi=null, pmid=null, pmcid=null, year=2021, volume=24, issue=6, pageStart=863, pageEnd=866, url=null, language=null, rfNumber=[47], rfOrder=52, authorNames=Liu M, Shi YH, Ying J, journalName=J Pract Hepatol, refType=null, unstructuredReference=Liu M, Shi YH, Ying J, et al. Prevalence of nosocomial infection and resistance of pathogens in patients with decompensated liver cirrhosis[J]. 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肝硬化合并细菌感染的治疗策略
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王芷婧 , 杨长青 *
解放军医学杂志 | 肝硬化及其并发症的评估与管理专题 2023,48(1): 1-6
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解放军医学杂志 | 肝硬化及其并发症的评估与管理专题 2023, 48(1): 1-6
肝硬化合并细菌感染的治疗策略
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王芷婧, 杨长青*
作者信息
  • 同济大学附属同济医院消化科/同济大学医学院消化疾病研究所，上海 200065

    • 王芷婧，硕士研究生，主要从事非酒精性脂肪性肝病和肝纤维化等肝脏疾病的基础研究

    杨长青，二级教授，主任医师，博士生导师，中国老年医学学会理事兼消化分会副会长，上海医学会肝病分会候任主任委员，上海中西医结合学会消化分会主任委员，上海领军人才，上海市优秀学科带头人。

通讯作者:

杨长青，E-mail：
Treatment strategies of bacterial infection in liver cirrhosis
Zhi-Jing Wang, Chang-Qing Yang*
Affiliations
  • Division of Gastroenterology and Hepatology/Digestive Disease Institute, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
出版时间: 2023-01-28 doi: 10.11855/j.issn.0577-7402.2023.01.0001
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摘要
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感染是肝硬化患者的常见并发症及主要死亡原因。近年来，人们逐渐认识到感染，尤其是自发性腹膜炎对肝硬化患者病程及预后有重要影响。及时有效的经验性抗感染治疗对肝硬化合并感染患者的治疗尤为关键，但由于多重耐药菌及广泛耐药菌的传播，肝硬化合并感染的治疗成为难点。随着研究的不断深入，肝硬化合并感染的发病机制逐渐明确，肠道微生态干预及免疫调节治疗等新型治疗手段已成为热点。为肝硬化合并感染患者制定有效的治疗方案是提高肝硬化患者生存率及生活质量的关键。

肝硬化  /  细菌感染  /  治疗

Infection is a common complication and leading cause of death in liver cirrhosis patients. In recent years, people gradually recognize the vital impact of infection, especially spontaneous bacterial peritonitis, on the course and prognosis of liver cirrhosis patients. Timely and effective empiric antibiotic therapy is particularly critical for the treatment of liver cirrhosis patients with bacterial infection. However, due to the spread of multidrug resistant bacteria and extensively drug-resistant bacteria, infection in cirrhosis has also become a difficult problem. At the same time, we have a clearer understanding on the pathogenesis of infection in cirrhosis. Novel therapeutic methods, such as intestinal microecological intervention and immunoregulatory therapy, have also become research hotspots recently. Establishing an effective treatment plan for liver cirrhosis patients with bacterial infections is the key to improve the survival rate and quality of life of these patients.

liver cirrhosis  /  bacterial infection  /  treatment
王芷婧, 杨长青. 肝硬化合并细菌感染的治疗策略. 解放军医学杂志, 2023 , 48 (1) : 1 -6 . DOI: 10.11855/j.issn.0577-7402.2023.01.0001
Zhi-Jing Wang, Chang-Qing Yang. Treatment strategies of bacterial infection in liver cirrhosis[J]. Medical Journal of Chinese People’s Liberation Army, 2023 , 48 (1) : 1 -6 . DOI: 10.11855/j.issn.0577-7402.2023.01.0001
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细菌感染是肝硬化患者的常见并发症之一，造成细菌感染的主要原因有肝功能障碍引起的体液及细胞免疫功能降低、肠道菌群失调[1]，以及门静脉高压导致的细菌易位加剧等，遗传因素也是影响该人群合并感染的病理生理学因素[2]。20%~60%的肝硬化患者在入院时或住院期间发生细菌感染，该比例是一般人群的4~5倍；且肝硬化患者比非肝硬化患者更容易发生严重感染，也更容易死于脓毒症；失代偿期肝硬化合并细菌感染患者的1个月内病死率达30%，1年内病死率达63%[2]。肝硬化合并新型冠状病毒感染患者的病死率也明显升高[3]。因此，肝硬化合并细菌感染的治疗显得尤为重要。
由国际腹水俱乐部发起的一项世界范围内的多中心临床研究表明，在肝硬化合并感染的住院患者中，社区获得性感染约占1/2，医院获得性、医疗保健相关性感染各占约1/4[4]。肝硬化合并感染以自发性腹膜炎及尿路感染多见，其次是肺炎、皮肤及软组织感染等。细菌感染多为革兰阴性菌导致，但革兰阳性菌也占据不低的比例。近年来，由多重耐药菌及广泛耐药菌引起的感染所占比例越来越高，在印度尤为明显[4]。由于肝硬化合并细菌感染病原体菌谱的变化，此类患者的抗感染治疗变得愈发复杂。一些新型治疗手段，如肠道微生态干预及免疫调节治疗等的应用，使肝硬化合并细菌感染的治疗更加多样化。除以上必要的药物治疗，针对肝硬化病因的治疗以及保肝治疗也必不可少。
1 抗感染治疗
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对于怀疑存在感染的肝硬化患者，在未获知病原菌及药敏试验结果前，经过综合评估后可给予经验性抗感染治疗。在治疗中需复查炎性因子及腹水实验室检测指标，评估抗感染治疗的效果，调整抗菌治疗方案。获得病原学结果后，尽快将经验性抗感染治疗转为目标性抗感染治疗。对病原微生物培养结果为阴性的患者，应根据经验治疗的效果及病情进展进一步检测，以明确病原体或调整经验性抗感染治疗方案。
1.1 自发性细菌性腹膜炎(spontaneous bacterial peritonitis，SBP)
SBP是指腹腔内没有感染灶，且没有与外界相通的损伤时发生的腹膜炎。SBP在肝硬化及腹水患者中比较常见，一旦肝硬化患者怀疑存在SBP，应立即开始经验性抗感染治疗。目前社区获得性SBP的治疗大多首选第三代头孢菌素、阿莫西林克拉维酸或喹诺酮类药物，经验性抗感染治疗至少应持续5~10 d[5]。过去20年，医院耐药菌的传播导致多重耐药菌感染的比例增加，给医源性感染的治疗带来了一定困难[6]。一项对国内社区获得性SBP及医源性SBP患者的比较研究表明，在两组中大多数细菌感染由大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌及肠球菌造成，医源性SBP组肠球菌感染的比例明显高于社区获得性SBP组[7]，主要病原菌对指南推荐的一线药物耐药率也较高[7-8]。因此，针对医源性SBP更容易对抗生素产生耐药的特性，在细菌多重耐药率较低的地区，建议使用哌拉西林/他唑巴坦，而碳青霉烯类抗生素可用于产超广谱β-内酰胺酶肠杆菌比例较高的地区，在革兰阳性多重耐药菌比例较高的地区，多用碳青霉烯类抗生素联合糖肽、达托霉素或利奈唑胺[9]。对于脓毒症或出现脓毒性休克的患者，建议早期选用广谱强效抗生素。有效的经验性抗菌治疗可明显降低肝硬化患者的住院病死率及发生重症的概率，减少住院时间[10]。若病原菌对初始抗生素治疗产生耐药性，则有可能增高患者的病死率[11]。一般选择在经验性抗感染治疗开始后48 h进行第2次腹腔穿刺术，以监测抗生素治疗的效果，如临床症状及体征恶化和(或)在48 h后白细胞计数升高或降低小于25%，则怀疑一线抗生素治疗失败[5,9]。需要注意的是，在经验性抗感染治疗前，需要留取样本进行细菌培养，待获得明确的病原学证据及药敏试验结果后，考虑进行降阶梯治疗[9]，因为降阶与升阶相比更不易产生耐药性。
1.2 其他细菌感染
1.2.1 呼吸系统感染
与非肝硬化患者相似，肝硬化患者发生社区获得性肺炎最常见的病原体是肺炎链球菌，医院获得性感染的主要病原体是革兰阴性杆菌及葡萄球菌[4]。对于社区获得性肺炎，推荐使用哌拉西林-他唑巴坦或大环内酯类药物联用头孢曲松。呼吸喹诺酮类药物(如左氧氟沙星或莫西沙星)是对β-内酰胺类药物过敏患者的替代品。对于医院获得性肺炎的治疗，欧洲肝脏研究协会(European Association for the Study of the Liver，EASL)建议将头孢他啶或美罗培南与左氧氟沙星联合使用，联合或不联合糖肽或利奈唑胺[9]。
1.2.2 泌尿系统感染
尿路感染在肝硬化患者中也较为常见。与普通尿路感染人群相似，在肝硬化合并尿路感染人群中，女性的发病率也明显高于男性[12]。尿路感染的主要致病菌是大肠埃希菌。患有尿路感染的晚期肝硬化患者90 d内死亡风险增加[13]。对于社区获得性尿路感染，目前对无并发症者推荐使用喹诺酮类药物及甲氧苄啶-磺胺甲恶唑，若出现脓毒症，则可静脉给予三代头孢菌素或哌拉西林/他唑巴坦。而对于医院感染，若无并发症，可用磷霉素或呋喃妥因；若合并脓毒症、严重脓毒症或脓毒性休克，则应使用碳青霉烯类药物(如美罗培南)治疗[14-15]。
1.2.3 皮肤及软组织感染
肝硬化合并皮肤及软组织感染比较少见，其中合并淋巴管炎及蜂窝织炎相对常见，感染病原体多为链球菌及金黄色葡萄球菌。对社区获得性感染常用第三代头孢菌素、苯唑西林或哌拉西林-他唑巴坦治疗，对医院感染可采用美罗培南、头孢他啶或糖肽等治疗[9,14]。对合并其他非SBP感染的患者，除了要考虑患者本身的肝病状态，还应将抗生素与单独发生该类感染的推荐治疗药物结合使用。
1.3 真菌感染
在失代偿期肝硬化晚期，当肝衰竭或肝性脑病患者出现免疫功能低下或应用大量广谱抗生素造成机体菌群失调时，易合并真菌感染。但与细菌感染相比，真菌感染的发生率明显较低。一项关于终末期肝病患者合并感染的研究发现，侵袭性真菌感染的发生率为15%[16]。肝硬化患者合并真菌感染最常见的病原体是念珠菌属，真菌感染的早期表现特异性不高，容易漏诊，可显著影响患者的生存率。为改善预后，目前有学者主张采用个体化分级抗真菌治疗方案，包括对未发生真菌感染的高危患者进行预防性治疗，对可能已经发生真菌感染的患者进行经验性治疗，对临床可能已经发生真菌感染但尚无病原学确诊证据的患者进行抢先治疗，对已有病原学证据的患者则根据药敏试验结果及感染部位进行靶向治疗[17]。
2 肠道微生态治疗
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由于肠-肝轴的存在，肠道菌群紊乱与肝硬化的发生发展密切相关[18]。目前认为，肠道微生物的组成及功能变化是肝硬化患者易发生感染的主要内部因素。一方面，肝硬化患者由于恶心、呕吐、纳差等原因导致肠道菌群营养不足，同时一些外部因素(如胃肠道淤血、广谱抗生素及抑酸剂的长期应用)可导致患者出现肠道菌群功能紊乱。另一方面，肝硬化患者的肠道黏膜屏障会随着疾病进展逐渐受损，同时肠道菌群失调(包括有益菌群减少，致病微生物增多，细菌功能改变)可造成肠道细菌及代谢产物大量进入肠外器官。在肝硬化患者易出现免疫功能障碍的前提下，易位的肠道微生物可造成感染及相关并发症[14]。因此，调节肠道微生态对肝硬化合并感染患者的治疗有着举足轻重的作用。
常用的肠道微生态制剂包括益生菌、益生元及合生元等，现有研究主要集中于益生菌。目前已知的益生菌制剂有200多种，其中乳酸菌及双歧杆菌最为常见。益生菌是指通过定植在人体内来改变宿主某一部位菌群组成的对宿主有益的活性微生物。尽管有指南推荐对SBP的预防及治疗可使用枯草芽孢杆菌、双歧杆菌、乳酸杆菌、酪酸梭菌等作为辅助[19]，但目前临床对于益生菌在肝硬化患者中的使用还存在争议，因为科研人员在研究乳酸杆菌能否代替诺氟沙星预防肝硬化患者肠道细菌易位及腹水感染时发现，应用乳酸杆菌并不能对感染起到预防作用[20]。在诺氟沙星中添加益生菌不能提高其对SBP的预防作用，也无法降低患者的病死率[21]。目前其他益生菌、益生元或合生元等在肝硬化合并感染患者中的应用研究仍较少，因缺乏高质量的临床证据，在肝硬化合并感染患者中使用肠道微生态制剂仍需谨慎。
口服肠道不吸收的窄谱抗生素，抑制肠道革兰阴性杆菌的过度增殖，保护肠道专性厌氧菌，改善肠道菌群结构也是一种有效的治疗方法。预防失代偿期肝病患者SBP的发生及复发可考虑口服此类抗生素。由于传统抗生素的耐药问题，利福昔明这种肠道不吸收的抗生素逐渐引起了研究者的关注。研究数据表明，利福昔明对肝硬化合并细菌感染患者有益[22]。粪菌移植也是肠道微生态干预的新方法，但其在治疗肝硬化合并感染方面的研究有待完善。
肠-肝轴与肠道微生态及肝病的密切关系不言而喻。尽管目前这方面的研究较少且存在争议，但不可否认的是，针对肠道微生态的治疗方法在肝硬化合并感染患者中具有良好的前景。
3 免疫调节治疗
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3.1 白蛋白
白蛋白是一种血液制品，能扩充血容量及维持血浆胶体渗透压，还具有载体以及维持毛细血管完整性等功能。人血白蛋白也可增强抗原呈递细胞对外来抗原的反应性，从而提升机体免疫能力[23]。多项研究表明，静脉注射白蛋白可减少SBP对循环功能的有害影响，遏制肾衰竭的发展，并提高患者的生存率[24-26]。国内《人血白蛋白用于肝硬化治疗的快速建议指南》建议，可在抗生药物治疗的基础上加用白蛋白治疗SBP[27]。国内专家认为国外指南推荐的白蛋白剂量偏大，临床需结合患者实际情况进行个体化应用，对于SBP低危患者(尿素<11 mmol/L及胆红素<68 μmol/L)则没必要使用白蛋白[28]。白蛋白的使用是否可以扩展到非SBP感染(如尿路感染、肺炎及皮肤软组织感染等)目前尚不清楚。一项比较单独应用抗生素与抗生素联合白蛋白治疗肝硬化合并非SBP感染患者的随机对照研究表明，联合治疗能够改善患者的肾脏及循环功能，并显示出潜在的生存益处[29]。但也有研究发现，接受两种方法治疗的患者住院病死率无统计学差异[30]；值得注意的是，该研究中联合治疗的患者随访前病情较单独应用抗生素组重，且在随访期间，联合组的慢加急性肝衰竭缓解比例高于单独治疗组(82.3% vs. 33.3%)，医院内感染发生率低于单独治疗组(6.6% vs. 24.6%)[30]。但是，关于白蛋白在肝硬化合并非SBP感染中的作用，目前还有第二种声音。一项发表于《新英格兰医学杂志》的研究表明，在失代偿期肝硬化住院患者中，靶向白蛋白治疗使其白蛋白水平维持在≥30 g/L，并未表现出明显益处，肝硬化患者是否需要应用白蛋白需要重新评估[31]。一项多中心随机对照研究[32]及Meta分析[33]表明，白蛋白不仅没有减轻非SBP感染患者的肾功能损伤及降低病死率，还增加了这类患者发生肺水肿的风险，对于病情严重的肝硬化患者，应谨慎输注大量白蛋白。目前的临床研究不足以明确白蛋白在非SBP感染中的益处。鉴于白蛋白价格、资源的限制以及患者的收益情况，肝硬化合并非SBP感染的患者目前不建议使用白蛋白。以上都是在肝硬化失代偿期出现感染或病情加重时启动白蛋白治疗的研究，而对于肝硬化合并感染患者长期应用白蛋白的获益情况，国内目前仍缺乏相应的临床数据。
3.2 胸腺肽α1
胸腺肽α1单独应用或联合乌司他丁治疗肝病合并感染患者可能有助于降低28 d病死率，而胸腺肽α1治疗肝硬化合并SBP有助于降低病死率及继发感染的发生率[34]。最新研究表明，胸腺肽α1治疗对乙肝相关性慢加急性肝衰竭患者是安全的，并可显著提高其90 d无肝移植生存率，降低新发感染及肝性脑病的发生率[35]。
3.3 免疫球蛋白
对于Child-Pugh评分为10~15分的中晚期肝病患者，目前多主张给予静脉注射免疫球蛋白(intravenous immunoglobulin，IVIG)联合抗菌药物治疗，以提高抗感染疗效；对于Child-Pugh评分小于10分的患者，联合用药及单一应用抗生素治疗的效率都很高[36]。考虑到免疫球蛋白的价格和资源问题，对此类患者应用免疫球蛋白获益不大。肝硬化晚期患者由于门静脉高压易出现脾功能亢进，可能面临行脾切除术的风险。脾切除术后凶险性感染(overwhelming post splenectomy infection，OPSI)是脾切除术后由于抗体生成受损或其他免疫功能受损引起的暴发性感染[37]。对于OPSI，抗生素及支持性医疗是治疗的基础，但辅助性IVIG对OPSI治疗也有显著效果。已有研究证实，在小鼠OPSI动物模型中IVIG是有效的[38]。除此以外，采用IVIG治疗的OPSI患者存活率也明显高于未接受IVIG治疗的患者，这可能是由于IVIG中含有特异性抗体[39]。OPSI患者最常见的病原体是肺炎链球菌，因此，IVIG的作用可能取决于患者体内肺炎链球菌特异性抗体的含量。除此以外，IVIG还有中和细菌内毒素、外毒素，以及增加抗炎介质等能力。因此，对于肝硬化OPSI患者可以应用IVIG提高生存率。
4 肝硬化合并细菌感染的预防
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尽管有Meta分析表明，抗生素对预防肝硬化合并细菌感染是否有益，以及哪种抗生素对有低蛋白或SBP病史的肝硬化腹水患者的预防效果最佳存在争议[40]，但目前主流的观点还是认为，对于急性胃肠道出血、晚期肝硬化腹水且总蛋白含量较低，以及既往有SBP病史的三类患者，要注意早期应用抗生素以预防SBP[41]。对不能口服药物的急性胃肠道出血及晚期肝硬化患者，应静脉注射头孢曲松进行一级预防，能口服药物的患者可口服喹诺酮类药物进行预防[42]。喹诺酮类耐药菌的日益增加对诺氟沙星在SBP预防中的突出作用提出了挑战[41]。喹诺酮类药物预防SBP的效果随用药时间延长显著下降，且该作用不是由肝脏疾病严重程度加重造成的[43]。除喹诺酮类药物外，利福昔明是一种耐药率较低的抗生素，越来越多的研究聚焦于其对SBP的预防作用。有研究表明，利福昔明在SBP的二级预防中比诺氟沙星更有效，不良事件发生率及病死率更低[22,44]。低剂量利福昔明也能显著降低肝硬化并发症的发生率，从而延长中晚期肝硬化患者的生存期[45]。尽管如此，利福昔明代替喹诺酮类作为一线预防药物尚需更多研究验证。对于多重耐药菌感染，预防性使用抗生素效果不明显[46]，需要进行定期筛查。
失代偿期肝硬化患者发生医源性感染的风险较高，且其中年龄大、住院时间长、消化道出血、血清白蛋白水平低的患者感染风险更高[47]，针对此类患者，医师应密切观察，尽可能预防感染的发生。
5 总结与建议
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对诊断为肝硬化合并细菌感染的患者，应尽可能早地开始经验性抗感染治疗。及早准确的经验性抗感染治疗能够降低肝硬化合并细菌感染患者的病死率。特别是对于脓毒性休克患者，延误使用抗生素会增加死亡风险。经验性抗感染治疗主要根据感染的类型及部位、存在多重耐药菌的可能性、感染的严重程度，以及当地的流行病学特征等因素选择方案。多重耐药菌及广泛耐药菌感染率的日益增高是过去20多年肝硬化合并感染流行病学的重要变化。多重耐药菌及广泛耐药菌导致感染治疗失败的风险增加，患者易发展为脓毒性休克，这是肝硬化感染管理中的一个重要挑战，在抗感染治疗中要尤其注意这一点。近年来，各大医药公司努力研制的新型抗菌药物，如头孢他啶-阿维巴坦、ceftolozane(第五代头孢类抗生素)-他唑巴坦、美罗培南-Vaborbactam(新一代β内酰胺酶抑制剂)等，也可考虑在广泛耐药菌感染的患者中使用。
在非抗菌治疗方面，调节肠道菌群微生态在肝硬化患者的治疗中前景良好，但目前的研究尚处于起步阶段，仍有大量问题亟待解决，如究竟哪种有益菌或哪种有害菌影响患者的疾病状态，菌种变化引起的发病机制是怎样的，如何将该种菌应用到临床患者的治疗中，以及治疗的具体方法、剂量及时间等。相信未来利用新型基因组学、代谢组学及菌群分析等手段，以上问题都会有新的突破。
免疫功能失调引起的感染给失代偿期肝硬化患者带来了巨大风险，大多数感染是由于肠道及腹部周围固有免疫屏障破坏导致的菌群易位引起的。过去几年中的研究已经确定了一些重要的免疫相关分子，如白蛋白、胸腺肽α1、丙种球蛋白等，这些分子可以增强免疫功能，达到防治感染的目的。但以上方法只是肝硬化合并细菌感染的辅助治疗措施，抗生素的合理选择仍是首要的关键。
基金
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  • 国家自然科学基金(81670571)
  • 国家自然科学基金(81820108006)
  • 上海市临床重点专科建设项目(SHSLCZDZK06801)
  • 上海申康三年行动计划重大临床研究项目(SHDC2020CR2030B)
文献
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参考文献 引证文献
排序方式：
[1]
Li BL, Huang HF, Wang XY, et al. Research progress of intestinal flora and hepatic encephalopathy[J]. Med J Chin PLA, 2021, 46(9): 860-864.
[李变玲, 黄会芳, 王晓阳, 等. 肠道菌群与肝性脑病的关系及其治疗措施研究进展[J]. 解放军医学杂志, 2021, 46(9): 860-864.]
[2]
Arvaniti V, D'Amico G, Fede G, et al. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis[J]. Gastroenterology, 2010, 139(4): 1246-1256.e5.
[3]
Bajaj JS, Garcia-Tsao G, Biggins SW, et al. Comparison of mortality risk in patients with cirrhosis and COVID-19 compared with patients with cirrhosis alone and COVID-19 alone: multicentre matched cohort[J]. Gut, 2021, 70(3): 531-536.
[4]
Piano S, Singh V, Caraceni P, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide[J]. Gastroenterology, 2019, 156(5): 1368-1380.e10.
[5]
Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D. Bacterial infections in cirrhosis: a critical review and practical guidance[J]. World J Hepatol, 2016, 8(6): 307-321.
[6]
Fernández J, Bert F, Nicolas-Chanoine MH. The challenges of multi-drug-resistance in hepatology[J]. J Hepatol, 2016, 65(5): 1043-1054.
[7]
Shi L, Wu D, Wei L, et al. Nosocomial and community-acquired spontaneous bacterial peritonitis in patients with liver cirrhosis in China:comparative microbiology and therapeutic implications[J]. Sci Rep, 2017, 7: 46025.
[8]
Cheong HS, Kang CI, Lee JA, et al. Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis[J]. Clin Infect Dis, 2009, 48(9): 1230-1236.
[9]
European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69(2): 406-460.
[10]
Wieser A, Li HW, Zhang J, et al. Evaluating the best empirical antibiotic therapy in patients with acute-on-chronic liver failure and spontaneous bacterial peritonitis[J]. Dig Liver Dis, 2019, 51(9): 1300-1307.
[11]
Lutz P, Nischalke HD, Krämer B, et al. Antibiotic resistance in healthcare-related and nosocomial spontaneous bacterial peritonitis[J]. Eur J Clin Investig, 2017, 47(1): 44-52.
[12]
Griemsmann M, Tergast TL, Simon N, et al. Nosocomial infections in female compared with male patients with decompensated liver cirrhosis[J]. Sci Rep, 2022, 12(1): 3285.
[13]
Reuken PA, Stallmach A, Bruns T. Mortality after urinary tract infections in patients with advanced cirrhosis - Relevance of acute kidney injury and comorbidities[J]. Liver Int, 2013, 33(2): 220-230.
[14]
Bajaj JS, Kamath PS, Reddy KR. The evolving challenge of infections in cirrhosis[J]. N Engl J Med, 2021, 384(24): 2317-2330.
[15]
Piotrowski D, Boroń-Kaczmarska A. Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment[J]. Adv Med Sci, 2017, 62(2): 345-356.
[16]
Hassan EA, El-Rehim ASA, Hassany SM, et al. Fungal infection in patients with end-stage liver disease: low frequency or low index of suspicion[J]. Int J Infect Dis, 2014, 23: 69-74.
[17]
Zhang L, Liu ZY. End-stage liver disease and invasive fungal infection[J]. Chin J Hepatol, 2018, 26(1): 13-16.
[张黎, 刘正印. 终末期肝病与侵袭性真菌感染[J]. 中华肝脏病杂志, 2018, 26(1): 13-16.]
[18]
Albillos A, de Gottardi A, Rescigno M. The gut-liver axis in liver disease: Pathophysiological basis for therapy[J]. J Hepatol, 2020, 72(3): 558-577.
[19]
Chinese Society of Microecology, Chinese Preventive Medicine Association. Chinese expert consensus on clinical application of microecological agents (2020 version)[J]. Chin J Clin Infect Dis, 2020, 13(4): 241-256.
[中华预防医学会微生态学分会. 中国微生态调节剂临床应用专家共识 (2020版)[J]. 中华临床感染病杂志, 2020, 13(4): 241-256.]
[20]
Bauer TM, Fernández J, Navasa M, et al. Failure of Lactobacillus spp. to prevent bacterial translocation in a rat model of experimental cirrhosis[J]. J Hepatol, 2002, 36(4): 501-506.
[21]
Pande C, Kumar A, Sarin SK. Addition of probiotics to norfloxacin does not improve efficacy in the prevention of spontaneous bacterial peritonitis: a double-blind placebo-controlled randomized-controlled trial[J]. Eur J Gastroenterol Hepatol, 2012, 24(7): 831-839.
[22]
Elfert A, Abo Ali L, Soliman S, et al. Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis[J]. Eur J Gastroenterol Hepatol, 2016, 28(12): 1450-1454.
[23]
Aubin E, Roberge C, Lemieux R, et al. Immunomodulatory effects of therapeutic preparations of human albumin[J]. Vox Sang, 2011, 101(2):131-137.
[24]
Fernández J, Monteagudo J, Bargallo X, et al. A randomized unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis[J]. Hepatology, 2005, 42(3): 627-634.
[25]
Fernández J, Navasa M, Garcia-Pagan JC, et al. Effect of intravenous albumin on systemic and hepatic hemodynamics and vasoactive neurohormonal systems in patients with cirrhosis and spontaneous bacterial peritonitis[J]. J Hepatol, 2004, 41(3): 384-390.
[26]
Salerno F, Navickis RJ, Wilkes MM. Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials[J]. Clin Gastroenterol Hepatol, 2013, 11(2): 123-130.e1.
[27]
Li HB, Men P, Wang Y, et al. Expert consensus on rapid advice guidelines for the pharmacological management of human albumin in patients with liver cirrhosis[J]. Clin Med J, 2018, 16(12): 10-16.
[李慧博, 门鹏, 王宇, 等. 《人血白蛋白用于肝硬化治疗的快速建议指南》解读[J]. 临床药物治疗杂志, 2018, 16(12): 10-16.]
[28]
Poca M, Concepción M, Casas M, et al. Role of albumin treatment in patients with spontaneous bacterial peritonitis[J]. Clin Gastroenterol Hepatol, 2012, 10(3): 309-315.
[29]
Guevara M, Terra C, Nazar A, et al. Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study[J]. J Hepatol, 2012, 57(4): 759-765.
[30]
Fernández J, Angeli P, Trebicka J, et al. Efficacy of albumin treatment for patients with cirrhosis and infections unrelated to spontaneous bacterial peritonitis[J]. Clin Gastroenterol Hepatol, 2020, 18(4): 963-973.e14.
[31]
China L, Freemantle N, Forrest E, et al. A randomized trial of albumin infusions in hospitalized patients with cirrhosis[J]. N Engl J Med, 2021, 384(9): 808-817.
[32]
Thévenot T, Bureau C, Oberti F, et al. Effect of albumin in cirrhotic patients with infection other than spontaneous bacterial peritonitis. A randomized trial[J]. J Hepatol, 2015, 62(4): 822-830.
[33]
Wong YJ, Qiu TY, Tam YC, et al. Efficacy and safety of IV albumin for non-spontaneous bacterial peritonitis infection among patients with cirrhosis: a systematic review and meta-analysis[J]. Dig Liver Dis, 2020, 52(10): 1137-1142.
[34]
Liver Failure and Artificial Liver Group, Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure (2018)[J]. Chin J Infect, 2019, 37(1): 1-9.
[中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南 (2018年版) [J]. 中华传染病杂志, 2019, 37(1): 1-9.]
[35]
Chen JF, Chen SR, Lei ZY, et al. Safety and efficacy of Thymosin α1 in the treatment of hepatitis B virus-related acute-on-chronic liver failure:a randomized controlled trial[J]. Hepatol Int, 2022, 16(4): 775-788.
[36]
Chen M, Zhu J, Yuan YL, et al. Clinical effect of human immunoglobulin combined with antibiotic therapy in patients with advanced liver infection[J]. Chin J Nosocomiol, 2016, 26(21): 4897-4899.
[陈敏, 朱俊, 袁玉林, 等. 人免疫球蛋白联合抗菌药物治疗中晚期肝病感染患者的临床效果研究[J]. 中华医院感染学杂志, 2016, 26(21): 4897-4899.]
[37]
Luu S, Spelman D, Woolley IJ. Post-splenectomy sepsis: preventative strategies, challenges, and solutions[J]. Infect Drug Resist, 2019, 12:2839-2851.
[38]
Nakamura K, Doi K, Okamoto K, et al. Specific antibody in Ⅳ immunoglobulin for postsplenectomy sepsis[J]. Crit Care Med, 2013, 41(8):e163-e170.
[39]
Nakamura K, Takahashi Y, Sonoo T, et al. Intravenous immunoglobulin for overwhelming postsplenectomy infection[J]. J Glob Infect Dis, 2021, 13(1): 44-51.
[40]
Komolafe O, Roberts D, Freeman SC, et al. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis[J]. Cochrane Database Syst Rev, 2020, 1: CD013125.
[41]
Facciorusso A, Antonino M, Orsitto E, et al. Primary and secondary prophylaxis of spontaneous bacterial peritonitis: current state of the art[J]. Expert Rev Gastroenterol Hepatol, 2019, 13(8): 751-759.
[42]
Fernández J, Tandon P, Mensa J, et al. Antibiotic prophylaxis in cirrhosis: good and bad[J]. Hepatology, 2016, 63(6): 2019-2031.
[43]
Mücke MM, Mücke VT, Graf C, et al. Efficacy of norfloxacin prophylaxis to prevent spontaneous bacterial peritonitis: a systematic review and Meta-analysis[J]. Clin Transl Gastroenterol, 2020, 11(8): e00223.
[44]
Pimentel R, Gregório C, Figueiredo P. Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in liver cirrhosis: systematic review[J]. Acta Gastroenterol Belg, 2021, 84(2): 333-342.
[45]
Zeng X, Sheng X, Wang PQ, et al. Low-dose rifaximin prevents complications and improves survival in patients with decompensated liver cirrhosis[J]. Hepatol Int, 2021, 15(1): 155-165.
[46]
Mücke MM, Mayer A, Kessel J, et al. Quinolone and multidrug resistance predicts failure of antibiotic prophylaxis of spontaneous bacterial peritonitis[J]. Clin Infect Dis, 2019, 70(9): 1916-1924.
[47]
Liu M, Shi YH, Ying J, et al. Prevalence of nosocomial infection and resistance of pathogens in patients with decompensated liver cirrhosis[J]. J Pract Hepatol, 2021, 24(6): 863-866.
[柳梅, 时永红, 郇娟, 等. 失代偿期肝硬化患者并发医院内感染病原菌类别及其耐药特点分析[J]. 实用肝脏病杂志, 2021, 24(6): 863-866.]
2023年第48卷第1期
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文章信息
doi: 10.11855/j.issn.0577-7402.2023.01.0001
  • 接收时间：2022-06-14
  • 首发时间：2025-12-03
  • 出版时间：2023-01-28
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  • 收稿日期：2022-06-14
  • 录用日期：2022-07-23
基金
National Natural Science Foundation of China(81670571)
国家自然科学基金(81670571)
National Natural Science Foundation of China(81820108006)
国家自然科学基金(81820108006)
Shanghai Key Clinical Specialty Project(SHSLCZDZK06801)
上海市临床重点专科建设项目(SHSLCZDZK06801)
Major Clinical Research Project of Shanghai(SHDC2020CR2030B)
上海申康三年行动计划重大临床研究项目(SHDC2020CR2030B)
作者信息
    同济大学附属同济医院消化科/同济大学医学院消化疾病研究所，上海 200065

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杨长青，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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