口服益生菌制剂预防腹膜透析相关腹膜炎的有效性研究  

Study on the efficacy of oral probiotic preparations in preventing peritoneal dialysis-related peritonitis

作　　者：黄彬三 陈勇平[1] 邱莉 蓝梅金 梁玉枫[1] HUANG Binsan;CHEN Yongping;QIU Li;LAN Meijin;LIANG Yufeng(Department of Nephrology,the Second Hospital of Longyan in Fujian Province,Fujian,Longyan 364000,China)

机构地区：[1]福建省龙岩市第二医院肾内科,福建龙岩364000

出　　处：《中国医药科学》2023年第5期130-133,共4页China Medicine And Pharmacy

基　　金：福建省龙岩市科技计划项目(2019LYF5012)。

摘　　要：目的 探讨益生菌制剂预防腹膜透析相关腹膜炎的有效性。方法 前瞻性收集2018年1月至2021年6月在龙岩市第二医院肾内科就诊的腹膜透析患者的临床基线资料、致病菌资料,按照随机数表法将透析治疗期间的患者分为益生菌制剂干预治疗的试验组(40例)和安慰剂治疗的对照组(55例)。所有患者至少随访12个月。比较两组患者的腹膜炎发生率,发生腹膜炎的诱因,以及发生腹膜炎的症状缓解时间。结果两组患者在年龄、基础疾病、肌酐、血红蛋白等基线资料方面差异无统计学意义(P> 0.05);与对照组相比,试验组腹膜透析相关性腹膜炎总体发生率下降(0.16次/患者年比0.39次/患者年,P=0.021);亚组分析显示,益生菌制剂治疗后革兰阴性菌腹膜炎发生率亦下降(0.05次/患者年比0.19次/患者年,P <0.05);且肠源性腹膜炎的发生率下降。将两组发生腹膜炎的患者的腹透液白细胞计数及各症状持续时间进行比较发现,试验组均有明显下降(P <0.05)。结论 口服益生菌制剂对腹膜透析相关腹膜炎的发生具有良好的预防效果以及辅助治疗效果。Objective To investigate the efficacy of probiotic preparations in preventing peritoneal dialysis-related peritonitis.Methods The clinical baseline data and pathogenic bacteria data of peritoneal dialysis patients visiting the Department of Nephrology of the Second Hospital of Longyan from January 2018 to June 2021 were prospectively collected.According to the random number method,the patients under dialysis treatment were divided into the experimental group(40 cases)treated with probiotic preparations and the control group(55 cases)treated with placebo.All patients were followed up for at least 12 months.The incidence of peritonitis,the precipitating factors for peritonitis,and the peritonitis symptom relief time were compared between the two groups.Results There were no statistically significant differences between the two groups in age,underlying diseases,creatinine,hemoglobin and other baseline data(P>0.05).Compared with that in the control group,the overall incidence of peritoneal dialysis-related peritonitis in the experimental group decreased(0.16 episodes/patient-year vs.0.39 episodes/patient-year,P=0.021).Subgroup analysis showed that the incidence of bacterial peritonitis caused by gram-negative bacteria also decreased after probiotic preparation treatment(0.05 episodes/patient-year vs.0.19 episodes/patient-year,P<0.05);and the incidence of enterogenous peritonitis also decreased.By comparing the leukocyte count in peritoneal dialysis fluid and the duration of each symptom between the two groups of patients with peritonitis,it was found that the experimental group showed a significant decrease(all P<0.05).Conclusion Oral probiotic preparations can exert good preventive and adjuvant therapeutic effects in preventing peritoneal dialysis-related peritonitis.

关 键 词：益生菌制剂 腹膜透析 腹膜炎 终末期肾脏病 

分 类 号：R692.5[医药卫生—泌尿科学]