不同透析龄的腹膜透析患者血清IL-17水平变化及转归

The changes and prognosis of serum IL-17 levels in peritoneal dialysis patients with different dialysis ages

目的分析不同透析龄的腹膜透析(PD)患者血清中白介素-17(IL-17)水平及其转归的危险因素.方法回顾性分析2018年1月至12月164例PD患者的临床资料,根据透析龄分为三组:LA组(透析龄≤3年);MA组(3年<透析龄≤6年);HA组(透析龄>6年),检测各组血清IL-17水平并探讨其转归的危险因素.结果不同透析龄组患者血清IL-17水平差异有统计学意义(P<0.001),HA组高于MA组(P<0.016),MA组高于LA组(P<0.016),回归分析显示血清IL-17与透析龄存在线性关系(P<0.05).Kaplan-Meier生存曲线分析发现HA组累计生存率低于MA组和LA组(P<0.05).多因素Cox回归分析提示血清IL-17是患者全因死亡的独立危险因素,糖尿病、腹透相关腹膜炎(PDAD)次数是患者退出PD的独立危险因素,血清白蛋白(Alb)是患者退出PD的独立保护因素.结论腹膜透析患者血清IL-17水平随透析龄的增加而增加,是患者全因死亡的独立危险因素.HA组患者具有较高的PD退出率.糖尿病、PDAD次数是患者退出PD的独立危险因素;Alb是患者退出PD的独立保护因素.

Objective To analyze the scerum level of interleukin-17(IL-17)and the risk factors of prognosis in peritoneal dialyis(PD)patients of different dialysis ages.Methods The clinical data of 164 patients with PD in our hospital from January 2018 to December 2018 were collected retrospectively.According to the dialysis age,the patients were divided into three groups:low dialysis age group(LA group dialysis age≤3 year),middle dialysis age group(MA group,3 years<dialysis age≤6 yeary),and high dialysis age group(HA group dialysis age>6 yer).The serum IL-17 levels of patients in different groups were detected and the risk factors of prognosis were discussed.Results There were significant differences in serum IL-17 levels among diferent dialysis age groups(P<0.001).The level of serum IL-17 in HA group was higher than that in MA group(P<0.016),and that in MA group was higher than that in LA group(P<0.016).There was a linear relationship between serum IL-17 and dialysis age(P<0.016).Muliple stepwise linear reresion showed that there was a linear relationship between serum IL-17 and dialysis age(P<0.05).Kaplan-Meier survival curve analysis showed that the cumulative survival rate in HA group was lower than that in MA group and LA group(P<0.05).There was no significant iference in cumulative survival rate between MA group and LA group(P>0.05).Multivariate Cox regesion analysis showed that serum IL-17 was an independent risk factor for ll-cause mortality diabetes and the number of Peritonitis dialysis-associated peritonitis(PDAD)was an indepe ndent risk factor for patients to withdraw from PD,and serum albumin was an independent protective factor for patients to withdraw from PD.Conclusion The serum IL-17 level in peritoneal dialysis patients increases with the increase of dialysis age,which is an independent risk factor for al-causle motality and has a positive value in judging the prognosis of patients.The high dialyis age group has a higher withdrawal rate of perioneal dialysis.Diabetes and PDAD times are independent risk factors for patients to withdraw from PD.Alb is an independent protective factor for patients withdrawing from PD.