慢性肾功能不全患者感染的临床特点及其相关因素分析

A Survey of Infection Episode and Related Risk Factors in Chronic Renal Failure Patients

目的:探讨慢性肾功能不全患者感染的临床特点及其相关因素。方法:对600例次慢性肾功能不全患者(血液透析180例次,腹膜透析110例次,非透析患者310例次)的住院资料进行回顾性分析,对感染部位、病原体、原发病因、肾功能状态及营养状况进行分析。结果:①慢性肾功能不全代偿期和失代偿期患者感染率(26.6%)明显低于肾功能衰竭期和尿毒症期的患者(46.8%)(P<0.05);原发病中糖尿病感染率最高;②细菌培养328例次,其中阳性268例次,以革兰氏阴性杆菌常见(46.3%);③感染组中血红蛋白、血清白蛋白显著低于非感染组(P<0.05);④血液透析患者的感染部位主要为肺部(46.4%)和静脉导管(21.3%),腹膜透析患者感染部位主要为腹腔;⑤血液透析和腹膜透析患者总体感染率差异无显著性(P>0.05),但是血液透析患者乙型肝炎病毒携带率(18.3%)和丙型肝炎病毒阳性率(8.7%)均高于腹膜透析患者(P<0.05),而腹膜透析患者腹腔真菌感染率却明显高于血液透析患者(P<0.05)。结论:慢性肾功能不全患者感染率较高,糖尿病感染多见。贫血、低蛋白血症、肾功能损害的严重程度、高龄等因素均可能增加慢性肾功能不全患者感染的机会。血液透析和腹膜透析患者总体感染率差异无显著,但血液透析患者乙型肝炎病毒携带率和丙型肝炎病毒阳性率均显著高于腹膜透析患者,而腹膜透析患者腹腔真菌感染率却明显高于血液透析患者。

Objective:To investigate the infection episode and related risk factors in chronic renal insufficiency patients.Methods: The relationship among infection and etiologies of infection、nutritional status、renal function、pathogens、causes of CRF were retrospectively analyzed in 600 chronic renal insufficiency patients(180 patients undergoing hemodialysis,110 patients undergoing peritoneal dialysis).Results:①The infection rate in non-dialysis patients was significantly lower than that in dialysis patients(P<0.05);②268 times positive in 328 times etiologic detection,Gram-negative germ were most common(46.3%);③ Hemoglobin and serum albumin decreased obviously in infectious patients;Diabetes patients were more susceptible to infection;④The main infectious site in hemodialysis and peritoneal dialysis patients was lung and peritoneal cavity respectively;⑤ The total infectious rate between hemodialysis patients and peritoneal dialysis patients was no significant differences,but the virus heptatic infectious rate in hemodialysis patients was higher than that in peritoneal dialysis patients,while the fungus infectious rate in peritoneal patients was higher than that in hemodialysis patients.Conclusions: There were higher infectious rate in chronic renal insufficiency patients.Diabetes patients were more susceptible to infection.Anemia、lower serum albumin、old age、server renal function status were susceptible factors.