肠型脂肪酸结合蛋白对腹膜透析相关腹膜炎患者的早期诊断价值

Intestinal fatty acid binding protein for early diagnosis patients with peritoneal dialysis-related peritonitis

目的探讨肠型脂肪酸结合蛋白(IFABP)对腹膜透析相关腹膜炎患者的早期诊断价值。方法回顾性收集2016年10月至2019年1月该院肾内科拟诊腹膜透析相关腹膜炎患者,记录患者入院时腹透液常规检查与IFABP水平及相关临床资料,运用受试者工作特征曲线(ROC曲线)评价各指标的诊断效能。结果共纳入163例研究对象包括非腹膜炎患者123例,腹膜炎患者40例。腹膜炎组腹膜透析时间、腹透液白细胞计数、中性粒细胞百分比和IFABP水平高于非腹膜炎组,差异有统计学意义(P<0.05)。IFABP水平对腹膜炎早期诊断价值最高,当IFABP水平最佳临界值为35ng/mL,诊断腹膜炎灵敏度为82.6%,特异度为86.8%。结论腹膜透析相关腹膜炎患者可能存在肠道屏障功能障碍,腹膜炎发生与IFABP水平相关,IFABP对于腹膜炎早期诊断具有一定的价值。

Objective To investigate the value of intestinal fatty acid binding protein for early diagnosis patients with peritoneal dialysis-related peritonitis.Methods We retrospectively collected the patients suspected peritoneal dialysis related peritonitis from October 2016 to January 2019 in the department of nephrology of this hospital,recorded the levels of peritoneal dialysis fluid examination and IFABP at admission and related clinical data,and evaluated the efficacy of each index with the receiver operating characteristic curve(ROC curve).Results A total of 163 subjects were included,including 123 non-peritonitis patients and 40 peritonitis patients.The peritoneal dialysis time,WBC count,neutrophil percentage and IFABP levels of peritoneal dialysis fluid in peritonitis group were higher than those in non-peritonitis group.The difference was statistically significant(P<0.05).IFABP had the highest value for early diagnosis of peritonitis.When the optimal threshold value of IFABP was 35 ng/mL,the sensitivity and specificity for the diagnosis of peritonitis were 82.6%and 86.8%respectively.Conclusion There may be intestinal barrier dysfunction in patients with peritoneal dialysis-related peritonitis.The occurrence of peritonitis is related to the level of IFABP.IFABP has certain value in the early diagnosis of peritonitis.