血清1-磷酸鞘氨醇、铁代谢水平诊断腹膜透析相关性腹膜炎发生的价值  

Diagnostic value of serum Sphingosine-1-phosphat and iron metabolism in peritoneal dialysis associated peritonitis

作　　者：司博林[1] 程慧栋 李婧 华琴[1] SI Bolin;CHENG Huidong;LI Jing;HUA Qin(Department of Nephrology,the Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院肾内科,江苏镇江212001

出　　处：《实用医学杂志》2021年第5期666-670,共5页The Journal of Practical Medicine

基　　金：江苏大学医学临床科技发展基金项目(编号:JLY20120152)。

摘　　要：目的探讨血清1-磷酸鞘氨醇(S1P)及铁代谢水平与腹膜透析(PD)患者发生腹膜炎的相关性。方法选择2016年8月至2019年8月在我院长期维持性PD患者160例,根据是否发生腹膜炎分为PD相关性腹膜炎患者34例(腹膜炎组),PD相关性非腹膜炎患者126例(非腹膜炎组),比较两组间血生化指标、S1P水平及铁代谢指标,评价不同铁代谢组间PD患者腹膜炎发生率,分析PD相关性腹膜炎发生的危险因素及血清CRP、S1P和SF水平对PD相关性腹膜炎的诊断价值。结果腹膜炎组与非腹膜炎组比较,血清S1P、总铁结合力(TIBC)水平明显下降,血清C反应蛋白(CRP)、血清铁(SI)、转铁蛋白饱和度(TSAT)水平明显升高(均P<0.05);与铁缺乏组和铁正常组比较,高铁蛋白组PD相关性腹膜炎发生率明显升高(P<0.05);多因素logistic分析示CRP、S1P、SF是PD相关性腹膜炎发生的独立危险因素(P<0.05)。ROC曲线示,血清CRP、S1P和SF水平对PD相关性腹膜炎的具有诊断价值(均P<0.05)。结论血清CRP、S1P、SF可作为PD相关性腹膜炎患者的特异性生物标志物。Objective To investigate the correlation among serum Sphingosine-1-phosphat(S1P),iron metabolism levels and the risk of peritoneal dialysis(PD)associated peritonitis.Methods Retrospective analysis of 160 patients with long-term maintenance PD in our hospital from August 2016 to August 2019 was conducted.According to the occurrence of peritonitis,34 patients with PD-associated peritonitis were chosen as peritonitis group and 126 patients with PD-associated non-peritonitis as non-peritonitis group.Blood biochemical index,S1P level and iron metabolism index were compared between the two groups,and the incidence of PD associated peritonitis among different iron metabolites were evaluated.The risk factors of PD-associated peritonitis and the diagnostic value of serum CRP,S1P and SF levels for PD-associated peritonitis were analyzed.Results The serum levels of S1P and total iron Binding force(TIBC)were significantly decreased,and the serum levels of c-reactive protein(CRP),serum ferritin(SF)and transferrin saturation(TSAT)were significantly increased in peritonitis group when compared with those in non-peritonitis group(All P<0.05).Compared with that in iron deficient group and iron normal group,the incidence of PD-related peritonitis was significantly increased in ferritin group.Multivariate logistic analysis showed that CRP,S1P and SF were independent risk factors for PD associated peritonitis(P<0.05).ROC curve showed that serum CRP,S1P and SF levels were of diagnostic value for PD-associated peritonitis(All P<0.05).Conclusion Serum CRP,S1P and SF can be used as specific bio-markers for patients with PD-associated peritonitis.

关 键 词：1-磷酸鞘氨醇 铁代谢 腹膜透析 腹膜炎 

分 类 号：R572.2[医药卫生—消化系统]