腹膜透析相关腹膜炎的易感因素分析
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摘要
目的:探讨腹膜透析相关腹膜炎的易感因素。方法:选取于江苏大学附属武进医院行腹膜透析导管置入术的患者76例进行回顾性分析。每位患者至少跟踪调查24个月,除非患者出现腹膜透析失功或者死亡。其中有40例患者并发有腹膜透析相关腹膜炎,设为腹膜炎组;另外36例患者没有并发腹膜透析相关腹膜炎,设为非感染组。对40例患者并发有腹膜透析相关腹膜炎再分三个时间点进行自身配对观察:置管前、感染前、感染后。结果:两组患者在性别、年龄、体重指数、原发病构成等方面差异无统计学意义。置管前腹膜炎组的血清碱性磷酸酶较非感染组高,外周血淋巴细胞较非感染组低,且均有统计学差异。腹膜炎组患者三个时间点自身配对比较发现,腹膜炎感染后分别与感染前及置管前相比,血清碱性磷酸酶、外周血淋巴细胞、血清白蛋白三者均有下降,且差异均有统计学意义。外周血淋巴细胞在感染前与置管前相比有所升高,且有统计学差异,但升高后计数仍在正常范围。结论:腹膜透析前外周血淋巴细胞计数降低及血清碱性磷酸酶升高均是易感腹膜透析相关腹膜炎的预测指标。
引文
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8 . Azab B,Daoud J,Naeem FB,et al. Neutrophil-to-Lymphocyte Ratio as a Predictor of Worsening Renal Function in Diabetic Patients(3-Year Follow-Up Study). Renal Failure,2012,34(5):571-576.
9 .龚立峰,卢景奎,唐卫刚,等.慢性肾脏病5期患者桡动脉钙化相关因素分析.北京医学,2012,34(2):146-148.
10 . Ye HJ,Lin XY,Qiu YG,et al. Higher alkaline phosphatase was associated with the short-term adverse outcomes of peritoneal dialysis-related peritonitis. Clin Chem Lab Med,2015,53(4):e113-e116.
11 . Kerschbaum J,Vychytil A,Karl Lhotta,et al. Treatment with Oral Active Vitamin D Is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis.PLOS ONE,2013,8(7):e67836-e67843.
12 . Tiana YT,Xiea XS,Xiang SL,et al. Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients. Kidney Blood Press Res,2017,42(6):1266-1276.
2 . Struijk DG. Peritoneal Dialysis in Western Countries. Kidney Dis,2015,1(3):157-164.
3 . Ma TKW,Chow KM,Kwan BCH,et al. Peritonitis before Peritoneal Dialysis Training:Analysisof Causative Organisms,Clinical Outcomes,Risk Factors,and Long-Term Consequences. Clin J Am Soc Nephrol,2016,11(7):1219-1226.
4 . Li PK,Szeto CC,Piraino B,et al. Peritoneal dialysis-related infections recommendations:2010 update. Perit Dial Int,2010,30(4):393-423.
5 . Bilen Y,Cankaya E,Bilen N,et al. Peritonitis Incidence Was Correlated with Duration of Peritoneal Dialysis Rather than Leptin or Neutrophil to Lymphocyte(N/L)Ratio in Peritoneal Dialysis Patients. Eurasian J Med,2014,46(3):145-150.
6 . Kumar VA,Sidell MA,Yang MT,et al. Predictors of Peritonitis,Hospital Days,and Technique Survival for Peritoneal Dialysis Patients in a Managed Care Setting. Perit Dial Int,2014,34(2):171-178.
7 . Griveas I,Papadopoulou D,Alexandra Fleva,et al. Comparison of Blood and Peritoneal Lymphocytes from Continuous Ambulatory Peritoneal Dialysis Patients,Asymptomatic and with Peritonitis.Renal Failure,2006,28(3):237-239.
8 . Azab B,Daoud J,Naeem FB,et al. Neutrophil-to-Lymphocyte Ratio as a Predictor of Worsening Renal Function in Diabetic Patients(3-Year Follow-Up Study). Renal Failure,2012,34(5):571-576.
9 .龚立峰,卢景奎,唐卫刚,等.慢性肾脏病5期患者桡动脉钙化相关因素分析.北京医学,2012,34(2):146-148.
10 . Ye HJ,Lin XY,Qiu YG,et al. Higher alkaline phosphatase was associated with the short-term adverse outcomes of peritoneal dialysis-related peritonitis. Clin Chem Lab Med,2015,53(4):e113-e116.
11 . Kerschbaum J,Vychytil A,Karl Lhotta,et al. Treatment with Oral Active Vitamin D Is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis.PLOS ONE,2013,8(7):e67836-e67843.
12 . Tiana YT,Xiea XS,Xiang SL,et al. Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients. Kidney Blood Press Res,2017,42(6):1266-1276.