营养不良和慢性炎症对肠炎相关性腹膜炎腹透患者的影响

Impact of Malnutrition and Chronic Inflammation on the Enteritis Peritoneal Dialysis-related Peritonitis

目的:探讨慢性炎症状态和营养状况对肠道感染相关性腹膜炎的腹膜透析患者的影响。方法:对我院腹膜透析中心2000年～2010年间收治的持续性不卧床腹膜透析并发腹膜炎的患者进行回顾性研究。将肠道感染相关性腹膜炎的患者(1组),其他原因导致的腹膜炎的患者(2组)作为对照,比较两组临床和实验室数据,分析肠道感染相关性腹膜炎与免疫功能、营养状况等的关系。结果:1组12例,发生感染性腹膜炎23例次,2组31例,发生感染性腹膜炎53例次。与2组相比,1组患者血压和水肿情况明显升高,CRP明显增加,血红蛋白和血浆白蛋白明显降低,SGA评分营养不良的发生率较高(以上所有数据P<0.05)。结论:与其他原因导致腹膜炎的患者相比,肠道感染相关性腹膜炎的患者的营养不良、慢性炎症和容量负荷较重。加强营养,积极治疗肠炎可能有助于该病的预防和控制。

Objective：To investigate the impact of nutritional status and chronic inflammation on the the enteritis peritoneal dialysis-related peritonitis.Methods：A retrospective analysis was conducted in the peritonitis patients undergoing continuous ambulatory peritoneal dialysis （CAPD） in our hospital.Patients were divided into two groups： enteritis PD-related peritonitis group（1 group,n=12）,others PD-related peritonitis group（2 group,n=31）.Their nutritional status （by SGA） ,chronic inflammation （by CRP） ,were evaluated.Results：Twenty-three episodes of peritonitis were recorded in the 12 patients with enteritis PD-related peritonitis（1 group）,as compared to 53 episodes in the 31 others PD-related peritonitis（2 group）.Compared with those in the 2 group,the patients with 1 group had significantly higher blood pressure,malnutrition and C-reactive protein（CRP） （all P0.05）,but lower hemoglobulin and plasma albumin,with higher rates of edema （all P0.05）.Conclusion：Compared with the patients with others PD-related peritonitis,the patients with episodes PD-related peritonitis have severer malnutrition,chronic inflammatory stata,and water overload.Severe anemia and proteinemia are risk factors and also predictive factors of episodes PD-related peritonitis.Measures to ameliorate anemia and proteinemia and effective management of episodes may help prevent and control episodes PD-related peritonitis.