老年营养风险指数与血液透析患者导管感染的相关性

Correlation between Geriatric Nutritional Risk Index and Catheter-related Infections of Hemodialysis Patients

目的探讨老年营养风险指数(GNRI)与血液透析患者无隧道和涤纶套透析导管(NCC)感染的相关性。方法回顾性分析2018年1月至2020年1月在广州市红十字会医院血液透析中心置入NCC行血液透析治疗的156例患者的临床资料,按诊断导管相关感染情况分为感染组和非感染组。比较两组患者的临床基线特征并分析NCC感染的影响因素。结果156例患者中发生导管感染24例,发生率为15.38%。感染组导管停留时间≤60 d、右股静脉置管、低GNRI患者比例高于非感染组[75.00%(18/24)比49.24%(65/132)、50.00%(12/24)比20.46%(27/132)、70.83%(17/24)比46.67%(62/132)](P<0.05或P<0.01),感染组GNRI、白蛋白水平低于未感染组[(83.4±5.8)比(86.6±6.5)、(28.6±4.0)g/L比(31.0±4.3)g/L](P<0.05)。多因素Logistic回归分析显示,低GNRI和右股静脉置管是NCC相关感染的独立危险因素(OR=3.217,95%CI 1.195~8.658;OR=4.454,95%CI 1.736~11.440)(P<0.05)。结论发生NCC感染的血液透析患者GNRI水平显著降低,低GNRI是血液透析患者发生NCC感染的独立危险因素。

Objective To investigate the correlation between baseline geriatric nutritional risk index(GNRI)and non-cuffed catheter(NCC)-related infections in hemodialysis patients.Methods A retrospective analysis was performed on 156 patients undergoing hemodialysis following the implantation of a NCC in Guangzhou Red Cross Hospital Hemodialysis Center from Jan.2018 to Jan.2020.The patients were divided into an infection group and a non-infection group.Clinical baseline indicators were compared between the two groups,and the influencing factors on NCC infection was analyzed.Results Catheter infection occurred in 24 cases among the 156 cases,the incidence was 15.38%.Catheter residence time≤60 d,the proportion of patients with right femoral vein catheterization and low GNRI in the infection group were higher than those of the non-infection group[75.00%(18/24)vs 49.24%(65/132),50.00%(12/24)vs 20.46%(27/132),70.83%(17/24)vs 46.67%(62/132)](P<0.05 or P<0.01),the levels of GNRI and albumin in the infection group were lower than those in the non-infection group[(83.4±5.8)vs(86.6±6.5),(28.6±4.0)g/L vs(31.0±4.3)g/L](P<0.05).Multivariate Logistic regression analysis showed that low GNRI and right femoral vein catheterization were independent risk factors for NCC-related infection(OR=3.217,95%CI 1.195-8.658;OR=4.454,95%CI 1.736-11.440)(P<0.05).Conclusion The level of GNRI of hemodialysis patients with NCC infection is significantly lower,and low GNRI was an independent risk factor for NCC infection in hemodialysis patients.