Abstract：Objective: To investigate continuous peritoneal dialysis-associated peritonitis (peritonitis), and to analyze the related serological risk indexes. Methods: A total of 416 patients with uremia undergoing peritoneal dialysis in the hospital were retrospectively enrolled between March 2021 and July 2022. The clinical data of patients were collected, including general data and laboratory indexes. The peritonitis infection and distribution of pathogens were recorded. According to presence or absence of peritonitis, they were divided into infection group and non-infection group, and differences in clinical data were compared between the two groups. The influencing factors of infection were analyzed. The risk prediction model based on laboratory indexes was constructed by binary Logistic regression model, and its predictive value was analyzed by ROC curves. Results: Among the 416 patients, there were 102 cases (24.52%) with peritonitis. There were 102 strains of pathogens, mainly on Gram-positive bacteria [62.75% (64/102), including Staphylococcus epidermidis 32.81% (21/64) and Staphylococcus aureus 26.56% (17/64)] and Gram-negative bacteria [34.31% (35/102)], including Escherichia coli [45.71% (16/35)]. The proportion of cases with education level of primary school and below in infection group was higher than that in non-infection group, dialysis age was longer than that in non-infection group, and residual renal function (RRF) was lower than that in non-infection group (P<0.05). The levels of hemoglobin (Hb) and albumin (ALB) in infection group were lower than those in non-infection group, while levels of serum C-reactive protein (CRP), white blood cell count (WBC) and ferritin (SF) were higher than those in non-infection group (P<0.05). The results of Logistic regression analysis showed that CRP, WBC, SF and ALB were risk factors of peritonitis. ROC curve analysis showed that the risk prediction model based on the above 4 indexes was of good predictive value (P<0.05). Conclusion: The main pathogen is Gram-positive bacteria in uremia combined with peritonitis. Low education level, long dialysis age and low RRF may increase the risk of peritonitis infection. CRP, WBC, SF and ALB are serological risk indexes to predict peritonitis, which have good predictive value for infection.
[1] Pope JE,Choy EH.C-reactive protein and implications in rheumatoid arthritis and associated comorbidities[J].Semin Arthritis Rheum,2021,51(1):219-229. [2] Tascini C,Aimo A,Arzilli C,et al.Procalcitonin,white blood cell count and C-reactive protein as predictors of S.aureus infection and mortality in infective endocarditis[J].Int Cardiol,2020,15(301):190-194. [3] Mahroum N,Alghory A,Kiyak Z,et al.Ferritin-from iron,through inflammation and autoimmunity,to COVID-19[J].Autoimmun,2022,1(126):102778. [4] Eckart A,Struja T,Kutz A,et al.Relationship of nutritional status,inflammation,and serum albumin levels during acute Illness:a prospective sudy[J].Am Med,2020,133(6):713-722. [5] 潘阳彬,林贝多,戴宾宾,等.益生菌对腹膜透析患者营养不良及腹膜炎发病率的影响[J].中国中西医结合肾病杂志,2020,21(6):493-496. [6] Perl J,Fuller DS,Bieber BA,et al.Peritoneal Dialysis-Related Infection Rates and Outcomes:Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)[J].Am Kidney Dis,2020,76(1):42-53. [7] 马东红,曹子彧,吕玉敏,等.腹膜透析相关性腹膜炎危险因素分析及预测模型建立[J].新乡医学院学报,2020,37(12):1168-1172. [8] 丁洁,李春庆,陈英兰,等.腹膜透析相关性腹膜炎病原菌及其影响因素[J].中华医院感染学杂志,2020,30(20):3099-3103. [9] 张俊,陈颖.老年患者腹膜透析相关性腹膜炎的相关危险因素及风险模型构建[J].老年医学与保健,2021,27(6):1265-1268. [10] Bonnal H,Bechade C,Boyer A,et al.Effects of educational practices on the peritonitisrisk in peritoneal dialysis:a retrospective cohort study with data from the french peritoneal dialysis registry (RDPLF)[J].BMC Nephrol,2020,21 (1):205. [11] Zhou J,Diao X,Wang S,et al.Diagnosis value of combined detection of serum SF,CEA and CRP in non-small cell lung cancer[J].Cancer Manag Res,2020,22(12):8813-8819. [12] 黎秋芬,方祎,王曲倔,等.PCT、CRP、腹水乳铁蛋白及LBP联合检测在自发性细菌性腹膜炎患者诊断中的临床价值[J].标记免疫分析与临床,2019,26(3):477-480.
2023, Vol. 29 
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