持续性不卧床腹膜透析相关性腹膜炎的影响因素研究

Risk Factors for Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis

目的探讨持续性不卧床腹膜透析(CAPD)相关性腹膜炎(CAPD-related peritonitis,CAPDrp)发生的影响因素。方法从患者的文化程度、发病季节、基础疾病、1年内复诊次数、营养状况及致病菌种类6个方面,回顾性分析我科近7年来收治的136例次CAPDrp的可能原因。结果高中和高中以上文化程度者CAPDrp发生的年平均例次明显低于高中以下文化者(P<0.05);每年5～9月发病者CAPDrp发生的年平均例次明显高于其他月份发病者(P<0.05);1年内复诊≥6次的患者CAPDrp发生的年平均例次低于<6次的患者(P<0.05)。血红蛋白≤80 g/L者与血红蛋白>80 g/L比较,清蛋白≤28 g/L者与清蛋白>28 g/L者比较,CAPDrp发生的年平均例次间差异均有统计学意义(P<0.05)。革兰阴性杆菌和真菌的感染率有上升趋势。结论 CAPDrp的发生与患者文化程度、发病季节、基础疾病、1年内复诊次数、营养状况关系密切;与终末期肾病(ESRD)的基础疾病关系不明显。

Objective To investigate the risk factors for continuous ambulatory peritoneal dialysis（CAPD）-related peritonitis（CAPDrp）.Methods The clinical data of 136 patients who suffered from CAPDrp in our center during the past 7 years were retrospectively analyzed in terms of education background,disease-onset season,underlying diseases,visits per year,nutritional status,and pathogen species.Results Patients with a higher education background（high school or higher） tended to have lower incidence of CAPDrp（P〈0.05）.CAPDrp was more often from May to September（P〈0.05）.Patients who had six or more visits per year suffered less times of CAPDrp（P〈0.05）.The incidence of CAPDrp was also significantly different in patients with hemoglobin（〉80 g/L vs.≤80 g/L） and serum albumin〉28 g/L vs.≤28 g/L（bothP〈0.05）.In addition,it also showed an increasing tendency after tuberculous bacillus and fungus infections.Conclusion CAPDrp is closely related with the patients′ education background,disease-onset seasons,underlying diseases,visits per year,and nutritional status;however,it shows no correlation with the underlying diseases of offend-stage ESRD.