腹膜透析患者首发腹膜透析相关性腹膜炎的影响因素分析  

Analysis of influencing factors of first episode peritoneal dialysis-associated peritonitis in patients with peritoneal dialysis

作　　者：马媛媛 任东升[1] 鲁冰[1] 石新慧 谷裕 张蓓 MA Yuanyuan;REN Dongsheng;LU Bing;SHI Xinhui;GU Yu;ZHANG Bei(Department of Nephrology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]河南省南阳市中心医院肾病内科,473000

出　　处：《淮海医药》2025年第2期132-135,共4页Journal of Huaihai Medicine

基　　金：2023年度南阳市科技发展项目(23KJGG096)。

摘　　要：目的:分析腹膜透析(PD)患者首发腹膜透析相关性腹膜炎(PDAP)的影响因素。方法:回顾性选取2021年12月—2023年12月某院行PD治疗后首次发生PDAP的79例患者为腹膜炎组,选取同期行PD治疗未发生PDAP患者86例为非腹膜炎组。比较2组一般资料、血清学指标[血红白蛋白(Hb)、基质金属蛋白酶(MMPs)、血钾、血磷、血钙、胱抑素C(CysC)]及尿液透明度(UCI);采用多因素Logistic回归方程分析PD患者首发PDAP的相关影响因素;绘制ROC曲线分析Logistic回归模型对PD患者首发PDAP的预测价值。结果:2组性别、年龄、原发疾病、文化程度、BMI及合并原发疾病情况比较,差异无统计学意义(P>0.05);腹膜炎组使用高糖透析液占比高于非腹膜炎组,透析龄长于非腹膜炎组,差异有统计学意义(P<0.05)。2组血磷、血钙、CysC及UCI水平比较,差异无统计学意义(P>0.05);腹膜炎组Hb、血钾水平低于非腹膜炎组,MMPs水平高于非腹膜炎组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,使用高糖渗透液(OR=2.830)、透析龄长(OR=1.034)、高MMPs水平(OR=1.468)是PD患者首发PDAP的危险因素,高Hb水平(OR=0.787)是PD患者首发PDAP的保护因素(P<0.05)。ROC分析显示,本研究Logistic回归模型预测PD患者首发PDAP的AUC为0.86(95%CI:0.824~0.986)。结论:透析龄长、使用高糖渗透液、高MMPs水平为PD患者首发PDAP的危险因素,高Hb水平为其保护因素,各影响因素联合检测对是否发生PDAP具有一定的预测价值。Objective:To analyze the influencing factors of the first episode PD-associated peritonitis(PDAP)in patients undergoing peritoneal dialysis(PD).Methods:79 patients who first developed PDAP after PD treatment from December 2021 to December 2023 were retrospectively selected as a peritonitis group,and 86 patients without PDAP in the same period were chosen as a non-peritonitis group.The general data,serum indexes[hemoglobin albumin(Hb),matrix metalloproteinases(MMPs),blood potassium,blood phosphorus,blood calcium,cystatin C(CysC)]and urine transparency(UCI)were compared between the two groups.Factors affecting the first episode PDAP in PD patients were analyzed using multivariate Logistic regression equation.ROC curve was drawn to analyze the predictive value of Logistic regression model on the first episode PDAP in PD patients.Results:There were no statistical differences between the two groups in terms of sex,age,primary disease,educational level,body mass index(BMI)and combined primary disease(P>0.05).The proportion of high glucose dialysate used in the peritonitis group was higher than that in the non peritonitis group,and the dialysis age was longer than the non-peritonitis group(P<0.05).Levels of phosphorus,calcium,CysC,and UCI were not significantly different between the two groups(P>0.05).Hb and potassium levels in the peritonitis group were lower than those in the non-peritonitis group,and MMPs level was higher than that in the non-peritonitis group(P<0.05).Multivariate Logistic regression analysis showed that use of high glucose dialysate(OR=2.830),long dialysis age(OR=1.034),high MMPs level(OR=1.468)were risk factors for first episode PDAP in PD patients,while high Hb level(OR=0.787)was a protective factor for first episode PDAP in PD patients(P<0.05).ROC analysis showed that the Logistic regression model of this study predicted an AUC of 0.86(95%CI:0.824 to 0.986).Conclusion:Long dialysis age,use of high glucose dialysate and high MMPs level are the risk factors for first episode PDAP in PD patients,whi

关 键 词：腹膜透析相关性腹膜炎 腹膜透析 影响因素 

分 类 号：R572.2[医药卫生—消化系统]