维持性腹膜透析相关腹膜炎的相关血清学风险指标分析

doi:10.3969/j.issn.1006-6233.2023.08.016

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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.

Key words： Uremia Peritoneal dialysis Peritoneal infection Serum protein

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.08.016 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I8/1313

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