腹膜透析相关性腹膜炎致病菌特点与血清降钙素原的相关性分析

Correlation analysis of pathogenic bacteria characteristics and serum calcitonin levels in peritoneal dialysis related peritonitis

目的分析腹膜透析相关性腹膜炎致病菌特点与血清降钙素原的相关性。方法选取胜利油田中心医院腹膜透析中心2013年1月至2017年12月腹膜透析相关性腹膜炎138例次,其中腹膜透析液细菌培养阳性97例次,根据培养结果分为革兰阳性菌组和革兰阴性菌组。比较2组之间血红蛋白、血清白蛋白、C反应蛋白、血清降钙素原等的差异性及与致病菌的相关性。结果腹膜透析相关性腹膜炎腹透液培养阳性97例(70.29%),其中革兰阳性菌(G^+)51例(52.58%),以表皮葡萄球菌、沃氏葡萄球菌为主;革兰阴性菌(G^-)46例(47.42%),以大肠埃希菌、阴沟肠杆菌为主。2组间在年龄、透析时间、季节性等一般资料间无差异(P>0.05);血清降钙素原有显著差异(P<0.01)。结论腹膜透析相关性腹膜炎以G+菌感染为主;血清降钙素原检测对区分G^+菌与G^-菌感染有参考价值。

Objective To analyze the correlation between the characteristics of pathogenic bacteria and the serum procalcitonin levels in peritoneal dialysis related peritonitis. Methods Select 138 cases peritoneal dialysis related peritonitis in the peritoneal dialysis center of Central Hospital of Shengli Oil Field,treated with peritoneal dialysis from January 2013 to December 2017,of which 97 cases were positive for peritoneal dialysis bacteria culture. According to the result of culture,it was divided into Gram-positive bacteria and Gram-negative bacteria groups. Comparison of the differences of hemoglobin,serum albumin,leukocyte,percentage of blood neutrophils,peritoneal leukocytes,peritoneal polykaryotes,c-reactive proteins,serum calcitonin,and the correlation with pathogenic bacteria between the two groups were compared. Results Peritoneal dialysis was associated with 97 cases（ 70. 29 %） of positive peritonitis peritoneal dialysis culture,including 51 cases（ 52. 58 %） of gram-positive bacteria（ G＋）,mainly epidermococcal staphylococcus and vaustenococcusaureus. Gram negative bacterium（ G^-） 46 cases（47. 42%）,mainly escherichia coli,enterobacter cloacae. Between the two groups in age,dialysis age,seasonality,hemoglobin,serum albumin,white blood cells,blood neutrophil percentage,peritoneal dialysate white blood cells,multinucleated cells and C reactive protein had no difference（ P 〉0. 05）,There was a significant difference in serum calcitonin levels（ P 〈0. 01）. Conclusions Peritoneal dialysis-related peritonitis was mainly caused by G^＋bacteria infection. The detection of serum calcitonin can be used to distinguish G＋bacteria from G^-bacteria infection.