透出液癌胚抗原125在腹膜透析患者腹膜感染时的变化与病原菌分布

Change of level of high liquid carcinoembryonic antigen 125 in peritoneal dialysis patients with peritoneal infections and distribution of pathogens

目的探讨透出液癌胚抗原125(CA125)在腹膜透析患者腹膜感染时的变化及病原菌分布,以期能为行腹膜透析的患者腹膜感染防治提供参考。方法选取行腹膜透析的230例患者,根据在腹膜透析期间是否发生腹膜感染进行分组,发生腹膜感染的26例患者为感染组,无腹膜感染的204例患者为非感染组,以电化学发光法检测透出液及血清中CA125水平,全自动生化分析仪检测C-反应蛋白(CRP),腹膜感染患者取透出液行细菌培养。结果腹膜感染组患者透出液CA125为(68.44±10.78)U/ml、血清CRP为(58.95±14.63)mg/L,高于非感染组(29.09±9.77)U/ml、(1.12±0.57)mg/L,两组比较差异有统计学意义(P<0.05);腹膜感染组患者抗感染治疗前透出液CA125水平、血清CRP水平为(68.44±10.78)U/ml、(58.95±14.63)mg/L高于感染控制后(29.87±9.89)U/ml、(5.27±2.03)mg/L,感染控制前后比较差异有统计学意义(P<0.05);26例腹膜感染患者腹膜透出液病原菌培养阳性率为100.00%,检出病原菌41株,其中革兰阴性菌17株占41.46%,革兰阳性菌24株占58.54%。结论腹膜透析患者腹膜感染后透出液中CA125及血清CRP明显升高,在感染控制后下降,感染病原菌以革兰阳性菌为主;检测透出液中CA125水平有助于评估患者腹膜感染严重程度。

OBJECTIVE To observe the change of level of the high liquid carcinoembryonic antigen 125 （CA125） in the peritoneal dialysis patients with peritoneal infections and explore the distribution of pathogens so as to provide guidance for prevention and treatment of peritoneal infections in the peritoneal dialysis patients .METHODS A total of 230 patients who underwent the peritoneal dialysis were enrolled in the study and were grouped according to the status of peritoneal infections during the peritoneal dialysis ：26 patients with peritoneal infections were assigned as the infection group ,and 204 patients without peritoneal infections were set as the non‐infection group .The levels of CA125 in the dialysates and serum were determined by using electrochemiluminescence assay ,the C‐reactive protein （CRP） was detected with the use of automatic biochemical analyzer ,and the dialysates were collected from the patients with peritoneal infections for the bacterial culture .RESULTS The level of CA125 in the dialysates was （68 .44 ± 10 .78）U/ml in the infection group ,significantly higher than （29 .09 ± 9 .77）U/ml in the non‐infection group;the level of serum CRP of the infection group was （58 .95 ± 14 .63）mg/L ,significantly higher than （1 .12±0 .57）mg/L of the non‐infection group（P〈0 .05） .The level of CA125 in the dialysates of the patients with peri‐toneal infections was （68 .44 ± 10 .78）U/ml before the treatment of infections ,significantly higher than （29 .87 ± 9 .89）U/ml after the control of infections ;the level of serum CRP of the patients with peritoneal infections was （58 .95 ± 14 .63）mg/L before the treatment of infections ,significantly higher than （5 .27 ± 2 .03）mg/L after the control of infections（P〈0 .05） .The positive rate of culture of pathogens from the dialysates was 100 .00% for the 26 patients with the peritoneal infections .Totally 41 strains of pathogens have been isolated , including＆amp;nbsp;17（41 .46% ） strains of gram‐negative bacteria and 24 （58 .54% ） strains of gram‐positive bacteria .CONCLUSION The levels of CA125 in dialysates and serum CRP of the peritoneal dialysis patients are remarkably elevated after they have the peritoneal infections .After the control of the infections ,the gram‐positive bacteria are the predomi‐nant pathogens .The detection of the level of CA125 in the dialysates may contribute to the evaluation of severity of the peritoneal infections .