腹膜透析相关性腹膜炎179例危险因素分析  

Analysis of risk factors of peritoneal dialysis-associated peritonitis in 179 patients

作　　者：黎多品 刘东伟[1] 赵子豪 王奕雪 张宇[1] 赵焕焕 潘少康 刘章锁[1] LI Duo-pin;LIU Dong-wei;ZHAO Zi-hao;WANG Yi-xue;ZHANG Yu;ZHAO Huan-huan;PAN Shao-kang;LIU Zhang-suo(Department of Nephrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肾内科,河南郑州450052

出　　处：《中国实用内科杂志》2022年第9期766-768,774,共4页Chinese Journal of Practical Internal Medicine

基　　金：河南省创新型科技人才队伍建设工程项目(182101510002)。

摘　　要：目的探讨终末期肾脏病患者行腹膜透析引起的腹膜透析相关性腹膜炎(PDAP)的危险因素。方法回顾性收集郑州大学第一附属医院2015年1月至2020年9月行持续性非卧床腹膜透析的809例终末期肾脏病患者(腹膜透析时间≥3个月)的随访终点的临床资料,分为PDAP组(179例)和对照组(630例),比较两组患者的人口学资料及实验数据的差异,并分析发生PDAP的危险因素。结果179例发生PDAP,发生率为22.13%。PDAP组年龄、透析龄显著高于对照组,差异有统计学意义(P<0.05);血红蛋白、血浆白蛋白、淋巴细胞绝对值显著低于对照组,差异有统计学意义(P<0.05);两组间白细胞计数、低密度脂蛋白、总胆固醇、血小板计数、血清钙、血清磷、尿素、肌酐及尿酸比较,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,腹膜透析患者年龄每增长1岁,发生PDAP的风险增加3%(OR 1.030,95%CI 1.015~1.045);透析龄每增加1个月,发生PDAP的风险增加2.4%(OR 1.024,95%CI 1.013~1.036);血浆白蛋白每增加1 g/L,发生PDAP的风险降低6.5%(OR 0.935,95%CI 0.907~0.965)。结论高龄和长透析龄是发生PDAP的独立危险因素,高血浆白蛋白是发生PDAP的保护因素。Objective To explore the risk factors of peritoneal dialysis-associated peritonitis(PDAP)caused by peritoneal dialysis in patients with end-stage renal disease.Methods Retrospectively collect clinical data of the follow-up endpoints of 809 patients with end-stage renal disease(peritoneal dialysis time≥3 months)who underwent continuous ambulatory peritoneal dialysis from January 2015 to September 2020 in the First Affiliated Hospital of Zhengzhou University,and they were divided into PDAP group(179 cases)and control group(630 cases).The demographic and experimental data of the two groups of patients were compared,and the risk factors for PDAP were analyzed.Results 179 cases of PDAP occurred,the incidence rate being 22.13%.The age and time of dialysis in PDAP group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);hemoglobin,plasma albumin and absolute lymphocyte value were significantly lower than the control group,the difference being statistically significant(P<0.05).There were no statistically significant differences in white blood cell count,low-density lipoprotein,total cholesterol,platelet count,serum calcium,serum phosphorus,urea,creatinine or uric acid between the two groups(P>0.05).The results of multivariate logistic regression analysis showed:the risk of PDAP increases by 3%for every 1 year increase in the age of peritoneal dialysis patients(OR 1.030,95%CI 1.015~1.045);the risk of PDAP increases by 2.4%for each month increase in the dialysis age of peritoneal dialysis patients(OR 1.024,95%CI 1.013~1.036);the risk of PDAP decreases by 6.5%for every 1g/L increase in the plasma albumin of peritoneal dialysis patients(OR 0.935,95%CI 0.907~0.965).Conclusion Old age and long dialysis time are independent risk factors for PDAP.High plasma albumin is a protective factor for PDAP.

关 键 词：腹膜透析 腹膜透析相关性腹膜炎 血浆白蛋白 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]