持续性非卧床腹膜透析患者发生首次相关性腹膜炎的危险因素分析  

Analysis of risk factors for first-time associated peritonitis occurred in patients with continuous ambulato⁃ry peritoneal dialysis

作　　者：何菊香 牛和俊 陈小元[1] HE Juxiang;NIU Hejun;CHEN Xiaoyuan(Department of Nephrology,Tongling People's Hospital,Tongling 244000,China)

机构地区：[1]铜陵市人民医院肾脏内科,安徽铜陵244000

出　　处：《老年医学研究》2021年第1期6-9,共4页Geriatrics Research

摘　　要：目的探讨持续性非卧床腹膜透析(CAPD)患者发生首次腹膜透析相关性腹膜炎(PDAP)的危险因素。方法选择新诊断慢性肾功能衰竭、采取腹膜置管透析治疗的CAPD患者94例。随访6个月至3年,依据腹膜透析期间是否发生腹膜炎分为首次发生PDAP组和非PDAP组。比较两组患者的基本情况、生化指标和透析相关指标等,采用多因素非条件logistic回归法分析导致首次PDAP发生的危险因素。结果94例CAPD患者中共有36例发生PDAP,发生率为38.29%(36/94)。与非PDAP组相比,首次发生PDAP组患者年龄较大(t=3.681,P<0.01)、血小板计数较高(t=7.491,P<0.01)、血红蛋白较低(t=-4.114,P<0.01)、白蛋白较低(t=-9.125,P<0.01)、尿酸较高(t=3.122,P=0.003)、血磷较高(t=5.411,P<0.01)、甘油三酯较低(t=-4.006,P<0.01)、合并糖尿病比例较多(χ2=15.332,P<0.01)。多因素非条件logistic分析显示,血小板计数升高、高磷和合并糖尿病是导致首次PDAP发生的危险因素,而白蛋白升高和血红蛋白升高是有效减少首次PDAP发生的保护因素(P均<0.05)。结论血小板计数升高、高磷和合并糖尿病是导致CAPD患者发生PDAP的危险因素,而白蛋白升高和血红蛋白升高是减少PDAP发生的保护因素。Objective To explore the risk factors of first-time associated peritonitis occurred in continuous ambulato⁃ry peritoneal dialysis(CAPD)patients.Methods A total of 94 CAPD patients who were newly diagnosed with chronic renal failure and were treated with peritoneal catheter dialysis were selected.According to whether peritonitis occurred dur⁃ing peritoneal dialysis,they were divided into PDAP group and non-PDAP group followed up for 6 months to 3 years.The basic conditions,biochemical indicators and dialysis-related indicators of the two groups were compared,and the multivari⁃ate unconditional logistic regression method was used to analyze the risk factors for first occurrence of PDAP.Results There were 36 cases of PDAP occurred in 94 patients,accounting for 38.29%(36/94).Compared with the non-PDAP group,PDAP group were older(t=3.681,P<0.01)and had higher platelets(t=7.491,P<0.01),lower albumin(t=-9.125,P<0.01),higher uric acid(t=3.122,P=0.003),higher blood phosphorus(t=5.411,P<0.01),lower triglycer⁃ides(t=-4.006,P<0.01),higher combined diabetes(χ2=15.332,P<0.01).Multivariate unconditional logistic analysis showed that the risk factors leading to the first-time PDAP were elevated platelet counts,high phosphorus,and combined diabetes,while elevated albumin and hemoglobin were protective factors that can effectively reduce the occurrence(all P<0.05).Conclusions Elevated platelet count,high phosphorus,and combined diabetes are risk factors for PDAP in CAPD patients,while elevated albumin and hemoglobin are protective factors which can reduce the occurrence of PDAP.

关 键 词：腹膜透析 腹膜透析相关性腹膜炎 肾功能衰竭 

分 类 号：R459.5[医药卫生—治疗学] R656.4[医药卫生—临床医学]