腹膜透析相关性腹膜炎对心血管事件影响的临床研究  

Clinical study on the impact of peritoneal dialysis associated peritonitis on cardiovascular events

作　　者：李萍 蔡明玉 侯世会 隗楷桢 杨杰 LI Ping;CAI Ming-yu;HOU Shi-hui;KUI Kai-zhen;YANG Jie(Department of Nephrology,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院肾内科,重庆400016

出　　处：《中国血液净化》2024年第1期41-45,共5页Chinese Journal of Blood Purification

基　　金：重庆市社会民生课题(cstc2018jscx-msybX0013)。

摘　　要：目的明确腹膜透析相关性腹膜炎是否是腹膜透析(peritoneal dialysis,PD)患者心血管事件的危险因素。方法回顾性分析在陆军军医大学大坪医院行PD治疗的患者,根据是否发生过腹膜炎分为腹膜炎组和非腹膜炎组。收集患者基线人口学及临床资料,随访期间腹膜炎发生情况、心血管事件,回归模型分析腹膜炎与心血管事件的关系。结果共纳入772例患者,458(59.3%)例患者在随访期间未发生腹膜炎,314(40.6%)例发生过腹膜炎。在随访过程中共有187例(24.2%)患者发生心血管事件。88例(47.1%)患者在腹膜炎发作后发生心血管事件,腹膜炎发作至心血管事件的中位时间为10.3(1.4,30.0)月,其中20例(22.7%)心血管事件发生在腹膜炎后30天内,68例(77.3%)心血管事件发生在腹膜炎30天后。腹膜炎组共107例(34.1%)患者发生过心血管事件,其中88例(82.2%)有腹膜炎先期发作,19例(17.8%)没有。非腹膜炎组共80例(17.5%)发生过心血管事件,结果表明腹膜炎发作的患者发生心血管事件的风险增加(OR=2.442,95%CI:1.746~3.416,P<0.001)。在校正了年龄、糖尿病和估算肾小球滤过率(estimated glomerular filtration rate,eGFR)后,腹膜炎引起心血管事件的风险仍然为2.434(95%CI:1.736~3.412,P<0.001)。结论腹膜透析相关性腹膜炎是腹膜透析患者心血管事件的危险因素。Aim To clarify whether peritoneal dialysis associated peritonitis is a risk factor for cardiovascular events in peritoneal dialysis(PD)patients.Methods The patients undergoing PD treatment in our peritoneal dialysis center were retrospectively analyzed.They were divided into peritonitis group and non-peritonitis group based on whether they had experienced the peritonitis.Their baseline demographic and clinical data were recruited.The occurrence of peritonitis and cardiovascular events were collected in follow-up study.Regression model was used to analyze the relationship between peritonitis and cardiovascular events.Results A total of 772 PD patients were included in this study,including 458(59.3%)in the non-peritonitis group and 314(40.6%)in the peritonitis group.During the follow-up period,cardiovascular events happened in 187 patients(24.2%),of which 88 patients(47.1%)presented the cardiovascular events after the onset of peritonitis and the median time from the onset of peritonitis to cardiovascular events was 10.3(1.4,30.0)months.In the 88 patients having cardiovascular events after peritonitis,20 patients(22.7%)experienced cardiovascular events within 30 days after peritonitis and 68 patients(77.3%)experienced cardiovascular events beyond 30 days after peritonitis.In the peritonitis group,cardiovascular events happened in 107 patients(34.1%),of which 88 patients(82.2%)had early onset of peritonitis and 19 patients(17.8%)did not;in the non-peritonitis group,cardiovascular events happened in 80 cases(17.5%).Therefore,the risk of cardiovascular events in PD patients was higher in PD patients with peritonitis episodes(OR 2.442,95%CI:1.746~3.416,P<0.001).After adjusting for age,diabetes and eGFR,the risk of cardiovascular events after peritonitis remained higher(2.434,95%CI:1.736~3.412,P<0.001).Conclusions Peritoneal dialysis associated peritonitis is a risk factor for cardiovascular events in PD patients.

关 键 词：腹膜透析 腹膜透析相关性腹膜炎 心血管事件 危险因素 

分 类 号：R459.5[医药卫生—治疗学]