单发与多发腹膜透析相关性腹膜炎的临床特点分析

Clinical characteristics of two groups of peritoneal dialysis-associted peritonitis with different incidence

摘要:

目的 探讨单发与多发腹膜透析相关性腹膜炎的临床特点，寻找多发性腹膜炎的危险因素。方法 选取2015年10月—2018年10月3年池州市人民医院长期随访的腹膜透析相关性腹膜炎患者58例作为研究对象。根据腹膜炎的发病次数分为单发组（3年间发病1次）和多发组（3年间发病≥2次）。收集纳入患者的一般资料，包括性别、年龄、文化程度，原发病、透析月龄、操作者及操作环境，以及实验室相关检查指标， 如初次发病前血红蛋白值、血浆白蛋白值、外周血白细胞计数、超敏C反应蛋白（hs-CRP）、初次发病病原菌培养情况。采用Logistic回归模型分析腹膜透析相关性腹膜炎发作的危险因素。结果 与单发组比较，多发组患者年龄较大，透析年限较长，总体文化程度较低（P?<0.05）。单发组基础疾病以慢性肾小球肾炎为主（19/42），而多发组以糖尿病肾病居多（10/16），两组在基础疾病的构成方面差异有统计学意义（P?<0.05）。单发组多数患者独立完成操作，有独立操作间的患者数比例较高。单发组初次发病前hs-CRP低于多发组，初次发病前血浆白蛋白高于多发组（P?<0.05）。两组其他指标比较，差异无统计学意义（P?>0.05）。而多因素Logistic回归分析结果显示透析月龄及初次发病前的血浆白蛋白水平是影响腹膜炎多发的独立危险因素（P?<0.05）。结论 透析月龄及初次发病前的血浆白蛋白水平可能是影响腹膜炎多发的独立危险因素。

Abstract:

Objective To investigate the clinical characteristics of single and multiple peritoneal dialysis-associted peritonitis, and to find out the risk factors of multiple peritonitis. Methods Fifty-eight patients with peritoneal dialysis-associted peritonitis were enrolled in our peritoneal dialysis center from October 2015 to October 2018. According to the incidence of peritonitis, they were divided into single group (once in three years) and multiple group (twice or more in three years). General data including gender, age, education level, primary disease, dialysis age, operator and operating environment, laboratory-related examination indicators, such as hemoglobin value, plasma albumin value, peripheral blood white blood cell count, hs-CRP and culture of pathogenic bacteria were collected and compared between the two groups by statistical methods. Results Compared with single group, the age of multiple group was older, dialysis age was longer, and the overall education level was lower (all P? 0.05). Multivariate logistic regression analysis showed that dialysis age and the level of plasma albumin before the first onset were independent risk factors for the occurrence of peritonitis (P?