透出液免疫球蛋白G与腹膜透析相关性腹膜炎的关系  

Relationship between Dialysate IgG and Peritoneal Dialysis Associated Peritonitis

作　　者：唐杏明[1] 郑玮[1] 胡洁萍[1] 唐俪文 邓惠钊 TANG Xing-ming;ZHENG Wei;HU Jie-ping;TANG Li-wen;DENG Hui-zhao(Department of Nephropathy and Rheumatism,Tungwah Hospital of Sun Yat-sen University,Dongguan 523000,China)

机构地区：[1]中山大学附属东莞东华医院肾病风湿免疫科,广东东莞523000

出　　处：《中山大学学报（医学科学版）》2021年第5期796-800,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：东莞市科技局2019年社会科技发展(重点)项目(201950715046061)。

摘　　要：【目的】分析规律腹膜透析的终末期肾脏病患者透出液免疫球蛋白G(IgG)水平与腹膜透析相关性腹膜炎(PDAP)之间的关系。【方法】采取回顾性队列研究分析方法,纳入2015年3月至2015年10月在我院规律腹膜透析的终末期肾脏病患者,收集患者基线水平临床资料、血生化资料,以及腹水蛋白定量。按照是否发生PDAP分为腹膜炎组和非腹膜炎组,比较两组患者之间的基线资料,采用Cox生存分析方法分析影响PDAP的危险因素。【结果】最终纳入61例规律腹膜透析患者,随访中位时间为43个月,发生腹膜炎患者占24.5%。两组比较发现,腹膜炎组的基线腹水中总蛋白、IgG、免疫球蛋白A(IgA)、转铁蛋白(TRF)均高于非腹膜炎组,而血清甘油三酯和血清胆固醇低于非腹膜炎组(P<0.1);基线透出液IgG越高,发生PDAP的风险越大;基线高透出液IgG(IgG>0.089 g/L)是腹膜炎发生的独立危险因素[HR=1.046,95%CI为(0.696,1.571),P=0.018]。【结论】基线高透出液IgG有助于预测PDAP的发生。【Objective】To investigate the relationship between dialysate immunoglobulin G(IgG)and peritoneal dialysis-associated peritonitis(PDAP)in patients with end stage renal disease(ESRD).【Methods】In this retrospective cohort study we enrolled 61 patients regularly followed up with ESRD between March 2015 and October 2015 in the Sun Yat sen University affiliated Tungwah Hospital and collected their clinical data at baseline.During the follow-up,the patients were divided into two groups according to whether they were diagnosed as PDAP.Characteristics at baseline were compared between the two groups.Cox survival analysis was used to find risk factors predicting the incidence of PDAP.【Results】Subjects were followed up for a mean period of 43 months,among whom 24.5%experienced PDAP.At baseline,the levels of dialysate total protein,IgG,immunoglobulin A(IgA)and Transferrin(TRF)in PDAP group were significantly higher than those of the non-PDAP group.But serum triglyceride and cholesterol were the opposite(P<0.1).An increased level of IgG was associated with a reduced risk of PDAP.Increased dialysate IgG was predictive of the incidence of PDAP[hazard ratio(HR)=1.046,95%CI(0.696,1.517),P=0.018].【Conclusion】High IgG baseline level is associated with higher risk of PDAP and IgG could be a potential predictor for PDAP.

关 键 词：腹膜透析 腹膜炎 透出液 免疫球蛋白G 

分 类 号：R5[医药卫生—内科学]