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肝硬化腹水并发原发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)者约占4～16％。而死亡率高达60～95％。因此,及时诊断SBP成为临床医师的一个迫切课题。然而,SBP患者由于腹水多寡不同,反应性不同,其临床症状与体征常不明显。已证明临床上常规用来鉴别渗出液与漏出液的有关腹水中的蛋白含量、比重等有明显的交叉而无鉴别的价值。而赖以确诊的腹水细菌培养至少需24～48小时,且阳性率不高。腹水沉渣涂片革兰氏染色的阳性率更低,仅占腹水培养阳性病例的1/4左右。近年来临床上曾探索其他方法,如腹水中的乳酸脱氢酶含量及其与血清中含量的比值、腹水蛋白含量与血清蛋
Cirrhosis with ascites and primary bacterial peritonitis (spontaneous bacterial peritonitis, SBP), about 4 ~ 16%. The mortality rate as high as 60 to 95%. Therefore, the prompt diagnosis of SBP as a clinician an urgent issue. However, patients with SBP due to the different amount of ascites, different reactivity, the clinical symptoms and signs are often not obvious. Has proved clinically routine to identify exudate and leakage of ascites in the protein content, specific gravity and other significant cross without the value of identification. The bacterial culture of ascites based on confirmed diagnosis takes at least 24 to 48 hours and the positive rate is not high. Ascites sediment smear Gram staining positive rate is lower, accounting for only about 1/4 of positive cases of ascites culture. In recent years, other methods have been explored in clinic, such as the content of lactate dehydrogenase in ascites and its ratio to the content of serum, the protein content of ascites and serum egg