单中心腹膜透析相关性腹膜炎危险因素分析  

Research on Risk Factors of Peritoneal Dialysis Related Peritonitis in a Single Center

作　　者：黄成文[1] 雷蕾[2] 林克宣[1] 郑庆发[1] 白建祥 姚嘉萍[1] 石咏军[1] 刘冠贤[1] 

机构地区：[1]广东省惠州市中心人民医院,广东惠州516001 [2]广东省惠州市第一人民医院

出　　处：《中国医学创新》2015年第20期1-5,共5页Medical Innovation of China

基　　金：广东省医学科学技术研究基金(A2013776)

摘　　要：目的:回顾性分析本中心持续性非卧床腹膜透析(Continuous Ambulatory Peritoneal Dialysis,CAPD)患者发生腹膜炎的临床资料,探讨影响腹膜炎发生及预后的危险因素。方法:对2008年1月-2013年12月在本院行腹膜透析置管术并长期固定本院随访的腹膜透析患者进行回顾性分析,(1)依照有无发生腹膜炎分为A组(腹膜炎组)和B组(非腹膜炎组),比较两组置管时临床资料并进行危险因素分析。(2)在患有腹膜炎的患者中依照疗效差异分为1组(病情反复或终止腹膜透析)和2组(经正规治疗后治愈),比较两组患病时的临床特征及实验室数据差异,分析其影响因素。结果:(1)A组的文化程度、HGB、ALB、血K水平均低于B组,舒张压高于B组,糖尿病及腹膜快速转运患者的比例高于B组,差异均有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,基础疾病为糖尿病、HGB≤80 g/L,ALB≤30 g/L以及腹膜快速转运为腹透相关性腹膜炎发生的危险因素。(2)1组的ALB水平低于2组,平均年龄高于2组,高糖腹透液的使用≥2袋/d、糖尿病以及腹膜快速转运患者比例高于2组,差异均有统计学意义(P<0.05或P<0.01)。Logistic回归提示ALB≤30 g/L、糖尿病、高糖腹透液的使用≥2袋/d为预后不良的危险因素。结论:文化程度较低、置管时存在低血红蛋白血症、低蛋白血症、低钾血症、基础疾病为糖尿病以及腹膜快速转运的患者发生腹膜炎概率较高,其中血红蛋白≤80 g/L、白蛋白≤30 g/L、糖尿病以及腹膜快速转运为腹膜炎发病危险因素。腹膜炎患者存在高龄、较高的高糖腹透液使用比例、糖尿病以及腹膜快速转运需警惕不良结局的发生,白蛋白≤30 g/L、糖尿病以及高糖腹透液的使用为预后不良的危险因素。Objective：To analyze the clinical data of continuous ambulatory peritoneal dialysis patients confronted with peritonitis retrospectively and to discuss the risk factors in the occurrence and the prognosis of peritonitis.Method：The peritoneal dialysis patients who planted with peritoneal dialysis catheter and were long-term fixed in our follow-up in our hospital from January 2008 to December 2013 were retrospectively analyzed.（1）Patients were divided into two groups according to whether they had peritonitis or not,patients in group A had peritonitis and patients in group B were free of peritonitis.The clinical data of the time when they were placed tubes was compared and the related risk factors were analyzed.（2）On the basis of therapeutic effect,peritonitis patients were divided into group 1（symptoms recurrent or quit peritoneal dialysis） and group 2（healing by formal treatment）,the two groups were also compared in the aspects of clinical characteristics and lab data.Result：（1）The educational status,levels of hemoglobin,albumin and serum potassium in group A were lower than those in group B,diastolic blood pressure was higher than the group B,the result was opposite when it came to the proportion of diabetes patients and fast peritoneal transport patients,the differences between the two groups were statistically significant（P〈0.05 or P〈0.01）.Logistic regression analysis showed that diabetes as the basic diseases,hemoglobin ≤ 80 g/L,albumin ≤ 30 g/L and peritoneal rapid transport type were the risk factors for the occurrence of peritoneal dialysis related peritonitis.（2）Group 1 showed a higher average age,proportion of high sugar concentration solution employment ≥ 2 bags/day,proportion of diabetes patients and proportion of patients with peritoneal rapid transport type but a lower albumin level than group 2,the differences were statistically significant（P〈0.05 or P〈0.01）.Logistic regression suggested that albumin ≤ 30 g/L,diabetes and the use of high sugar con

关 键 词：腹膜炎 腹膜快速转运 危险因素 

分 类 号：R459.5[医药卫生—治疗学] R572.2[医药卫生—临床医学]