低血清白蛋白血症腹膜透析相关性腹膜炎临床研究  

Characteristics of hypoalbuminemia in patients with peritoneal dialysis related peritonitis

作　　者：叶元君[1,2] 张晓辉[1] 寿张飞[1] 

机构地区：[1]浙江大学医学院附属第一医院肾脏病中心,杭州310003 [2]浙江省义乌市中心医院肾内科

出　　处：《中国实用内科杂志》2014年第7期689-692,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金资助(81170707)

摘　　要：目的观察基础低蛋白血症的腹膜透析相关性腹膜炎患者在原发基础疾病、腹膜透析液培养结果、致病原因及转归等方面的特点。方法对2009年9月至2013年3月在浙江大学附属第一医院腹膜透析中心随访的223例次腹膜透析相关性腹膜炎进行回顾分析,按基础血清白蛋白(ALB)水平将患者分为L(low)组(ALB≤35g/L组)和N(normal)组(ALB>35g/L组),对两组资料进行比较。结果在肾脏原发病的比较中,L组继发性肾病所占比例高于N组(P<0.05)。223例次均送腹膜透析液培养,L组55例次,其中培养阴性29例(阴性率52.7%),N组168例次,其中培养阴性58例(阴性率34.5%)(P<0.05)。L组腹膜炎致病原因中原因不详所占比例最高,N组最常见的致病原因为操作污染(P<0.01)。L组病死率高于N组(P<0.05)。结论 L组与N组相比,腹膜透析液培养阴性率、病死率高,致病原因和原发病差异有统计学意义。Objective To observe the characteristics of hypoalbuminemia patients accompanied by peritoneal dialysis relat ed peritonitis in terms of primary basic diseases,training results,causes and the prognosis. Methods We retrospectively analyzed 223 episodes of CAPD related peritonitis who followed up in Peritoneal Dialysis Center of Zhejiang University First Hospital from September2009 to March2013. Patients were divided into hypoalbuminemia plasma albumin group（L group）and normal group（N group）. Then the two groups were compared. Results In terms of the primary disease,the proportion of secondary kidney disease was higher in L group than in H group（P 0.05）. All cases underwent cultivation of perito neal dialysis solution. Culture negative rate was 52.7% in the H group and 34.5% in the N group（P 0.05）. In terms of pathogenic factors,unknown causes ranked highest in the H group while operating contamination was the most common cause in the N group（P 0.01）. In addition,the H group had a higher mortality rate than the N group（P 0.05）. Con clusion Compared with the normal plasma albumin group,the hypoalbuminemia group has the features of higher culture negative rate,and high mortality rate. Meanwhile,significant difference was detected in the primary disease and pathogenic factors between the two groups.

关 键 词：腹膜透析 腹膜炎 低蛋白血症 肠源性腹膜炎 肠道微生态 

分 类 号：R459.5[医药卫生—治疗学]