质子泵抑制剂与肝硬化患者自发性细菌性 腹膜炎发病相关性研究
Study on the Association between Proton Pump Inhibitor and Onset of Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis
摘要: 自发性细菌性腹膜炎(SBP)是终末期肝病(ESLD)患者最常见的并发症之一，增加了其短期死亡的风险。质子泵抑制剂(PPIs)是临床常用的抑酸药物，多用于治疗反流性食管炎、消化性溃疡等临床疾病，也被用于根除幽门螺杆菌的四联疗法。近年来，PPIs也有被应用于肝硬化失代偿期患者治疗方案的案例，用于预防及治疗肝硬化患者并发的胃底–食管静脉曲张破裂出血，因其良好的疗效而被越来越多地应用于肝硬化患者人群的长期治疗方案中。有文献表明，PPIs的不规范使用与肝硬化失代偿期患者发生SBP的风险具有相关性。本文就临床应用PPIs对肝硬化患者SBP发生和预后的不良影响进行综述，并描述了PPIs可能诱导SBP发生的潜在机制，旨在为临床上PPIs在肝硬化患者人群中的合理使用提供参考。
Abstract: Spontaneous bacterial peritonitis (SBP) is one of the most common complications in patients with end-stage liver disease (ESLD), increasing the risk of short-term death. Proton pump inhibitors (PPIs) are commonly used in clinical acid suppression drugs, mostly used in the treatment of reflux esophagitis, peptic ulcer and other clinical diseases, but also used to eradicate Helicobacter pylori in quadruple therapy. In recent years, PPIs have also been used in the treatment of decompensated patients with liver cirrhosis. They are used to prevent and treat gastroesophageal variceal bleeding in patients with liver cirrhosis. Because of their good efficacy, PPIs are increasingly used in long-term treatment programs for patients with liver cirrhosis. There is literature showing that the irregular use of PPIs is associated with the risk of SBP in decompensated patients with liver cirrhosis. This article reviews the adverse effects of PPIs on SBP occurrence and prognosis in patients with cirrhosis, and describes the potential mechanisms of PPIs that may induce SBP, so as to provide a reference for rational clinical use of PPIs in patients with cirrhosis.
文章引用：吴义炜, 曾爱中. 质子泵抑制剂与肝硬化患者自发性细菌性 腹膜炎发病相关性研究[J]. 临床医学进展, 2026, 16(2): 2638-2645. https://doi.org/10.12677/acm.2026.162673

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