培养阴性的腹膜透析相关性腹膜炎的血清铁水平、原因及预后的探讨

Discussion on serum iron level, causes and prognosis of peritoneal dialysis-related peritonitis in culture-negative patients

摘要:

目的 探讨培养阴性的腹膜透析（PD）相关性腹膜炎的血清铁水平、原因及预后。方法 回顾性分析2010 年1 月-2016 年6 月广西医科大学第一附属医院发生腹膜透析相关性腹膜炎的患者共64 例，其中腹膜透析液培养阳性者有32 例，培养阴性者有32 例，对比分析培养阴性及培养阳性腹膜透析相关性腹膜炎患者血清铁水平、入院前抗生素的使用及治疗转归的差异。结果 培养阳性组的血清铁平均水平（5.560±3.255）μmol/L，培养阴性组的血清铁平均水平（8.732±5.351）μmol/L，两者相比，差异有统计学意义（P <0.05），腹膜透析液培养阳性组和阴性组在住院前使用抗生素的例次分别为3 和12 例，差异有统计学意义（P <0.05），经比较培养阳性组与培养阴性组的治疗效果差异无统计学意义（P >0.05）。结论 培养阴性的腹膜透析相关性腹膜炎的产生与近期使用抗生素有关，血清铁水平较高，完全治愈率与培养阳性者相当。

关键词:腹膜透析;腹膜炎;血清铁;培养阴性

Abstract:

Objective To study the serum iron level, reasons and prognosis of peritoneal dialysis (PD)-related peritonitis in culture-negative patients. Methods The dada of 64 patients with PD-related peritonitis in the First Affiliated Hospital of Guangxi Medical University from January 2010 to June 2016 were retrospectively analyzed.Among them 32 cases were positive for the culture of peritoneal fluid, 32 cases were culture-negative. The differences in the serum iron levels, the use of antibiotics prior to admission, and treatment outcome were compared between the culture-negative and culture-positive patients with PD-related peritonitis. Results The average serum iron level was(5.560 ± 3.255) μmol/L in the culture-positive patients and (8.732 ± 5.351) μmol/L in the culture-negative patients, the difference was statistically significant (P < 0.05). The number of the patients who used antibiotics prior to admission was 3 in the culture-positive group and 12 in the culture-negative group, the difference was statistically significant(P < 0.05). The therapeutic effect was not statistically different between the two groups (P > 0.05). Conclusions In the culture-negative patients, peritoneal dialysis-related peritonitis is associated with the recent use of antibiotics,serum iron level is higher, but their complete cure rate is similar to that of the culture-positive patients.

Key words:peritoneal dialysis; peritonitis; serum iron; culture negative