血液透析患者导管相关血流感染的危险因素分析

To Analyse the Risk Factors of Dialysis Cuff Central Venous Catheter-related Bloodstream Infections

目的:分析血液透析(HD)患者带涤纶环中心静脉留置导管相关血流感染(CRBSI)的危险因素。方法:对我科带涤纶环中心静脉留置导管的患者进行了前瞻性研究。导管插入后及插入后1个月记录实验室和临床变量,取平均值分析,临床过程跟踪到满2年,导管失败或CRBSI被记录为终点事件,期间根据患者是否CRBSI分为感染组或非感染组。结果:CRBSI组患者C-反应蛋白(CRP)、年龄、低密度脂蛋白(LDL)显著高于非感染组;而血白蛋白(Alb)、标准化蛋白分解率(nPCR)低于非感染组。患者CRBSI的危险因素为:CRP、nPCR、糖尿病。结论:营养状况、微炎症状态、血脂与HD带涤纶环中心静脉留置导管CRBSI有关,CRP、nPCR、糖尿病是CRBSI的危险因素。

Objective：To analyse the risk factors of dialysis cuff central venous catheter-related bloodstream infections（CRBSI）.Methods：This was a prospective study,Hemodialysis（HD）patients with cuff central venous cathetes was studied.After catheterization and one month later,Laboratory and clinical variables was recorded.Took the mean value analysis,The clinical course of tracking to 2years,endpoint events was recorded as catheter failure or CRBSI.All patients were divided into CRBSI and no CRBSI.Results：The serum C-reactive protein（CRP）,age,low density lipoprotein（LDL）in HD with CRBSI were significantly higher than those without CRBSI patients.But the serum albumin（Alb）and normalized protein catabolic rate（nPCR）were significantly decreased.The risk factors of HD patients with CRBSI were CRP,nPCR and primary diabetes.Conclusion：There were relationship between nutritional status,micro-inflammation,blood lipids and CRBSI in HD with cuff central venous catheter patients,CRP,nPCR,diabetes is a risk factor of HD patients with CRBSI.