老年腹膜透析患者发生感染的危险因素分析

Predictive factors of infection in elderly peritoneal dialysis patients

目的探讨老年腹膜透析患者发生感染的危险因素。方法回顾性分析长海医院近3年来腹膜透析住院患者的年龄、性别、腹透龄、是否合并糖尿病、住院时间、是否出现感染、感染的部位和次数，以及各实验室指标，采用单因素分析和Logistic回归分析寻找感染的危险因素。结果共纳入93例腹透患者，其中男57例，女36例，年龄为（21—87）岁，平均年龄为（58．4±18．6）岁。3年中共住院289次，其中53例发生过感染，各部位累计感染113例次．与44例非老年组（〈60岁）相比，49例老年组（≥60岁）的感染率高（33／49vs．20／44，P=0．033）、糖尿病患者多、血肌酐低、C反应蛋白（CRP）高．在老年腹透患者中，与非感染组比较，感染组的年龄大、腹透龄长、住院时间长、CRP高、白蛋白低．单因素Logistic回归分析显示，感染组的年龄大（OR1．045，95％CI1．015-1．076，P=0．003）、住院时间长（OR1．582，95％CI1．261-1．984，P〈0．001）、CRP高（OR1．066，95％CI1．012-1．124，P=0．017）和白蛋白低（OR0．846，95％CI0．765-0．935，P=0．001）。结论老年人、住院时间长、血清CRP高和白蛋白低是腹透患者发生感染的危险因素。

Objective To explore the possible predictive factors of infection in elderly peritoneal dialysis （PD） patients. Methods The general information, such as age, gender, duration of PD, concurrent diabetes mellitus, length of hospital stay, occurrence of infection, and results of laboratory tests of hospitalized PD patients in the recent 3 years were collected. Chisquare test, t -test and logistic regression analysis were used to explore the possible predictive factors of infection. Results A total of 93 hospitalized PD patients were included, with 57 men and 36 women, and the mean age was 58.4± 18.6 （21-87） years. Of the 93 patients, 53 experienced infection existed in a period of 3 years, with 113 incidences of infection in a total of 289 hospitalizations. Of the 93 patients, 49 were the elderly patients. The elderly patients were associated with a higher incidence of infection （33/49 vs 20/44,P=0.033）, higher incidence of diabetes mellitus, lower level of serum creatinine, and higher level of CRP than the non-elderly patients. For the elderly PD patients, the infected group had a higher mean age, longer duration of PD, longer hospital stay, higher level of CRP and lower level of albumin than the non-infected group. Univariate logistic analysis showed that, PD patients with higher age （OR 1.045, 95 % CI 1.015-1.076, P=0.003）, longer hospital stay （OR 1.582, 95 % CI 1.261-1.984, P〈0.001）, higher level of CRP （OR 1.066, 95 % CI 1.012-1.124, P=0.017） and lower level of albumin （OR 0.846, 95 % CI 0.765-0.935, P=0.001） were associated with increased incidences of infection. Conclusions Age, length of hospital stay, level of serum CRP and albumin are predictive factors of infection in peritoneal dialysis patients.