腹膜透析感染性腹膜炎病原菌及血清和透出液sICAM-1、PCT、CRP的临床意义

Distribution of pathogenic bacteria in patients with infectious peritonitis in peritoneal dialysis and clinical significance of serum,peritoneal fluid sICAM-1,PCT and CRP

目的探讨腹膜透析(PD)感染性腹膜炎患者病原菌分布及血清、透出液可溶性细胞间黏附分子-1(sI-CAM-1)、降钙素原(PCT)、C-反应蛋白(CRP)对其的预测价值.方法选取2020年5月—2023年5月简阳市人民医院收治的62例PD感染性腹膜炎患者(研究组)和64例PD未发生感染性腹膜炎患者(对照组).分析研究组致病菌分布;比较两组血清、透出液sICAM-1、PCT、CRP水平,分析血清、透出液sICAM-1、PCT、CRP水平对PD感染性腹膜炎的预测价值.结果62例PD感染性腹膜炎患者共培养出病原菌63株,主要为大肠埃希菌、金黄色葡萄球菌;研究组血清、透出液sICAM-1、PCT、CRP水平均高于对照组,差异具有统计学意义(P<0.05);血清sICAM-1、PCT、CRP水平联合检测对PD感染性腹膜炎患者的曲线下面积(AUC)值高于单独检测,且联合检测的敏感度为88.71%,特异度为92.19%;透出液sICAM-1、PCT、CRP水平联合检测对PD感染性腹膜炎患者的AUC值高于单独检测,且联合检测的敏感度为88.71%,特异度为93.75%.结论PD患者感染性腹膜炎主要病原菌为大肠埃希菌和金黄色葡萄球菌,该病与sICAM-1、PCT、CRP水平变化有关,且三者联合检测对其预测价值较高.

OBJECTIVE To investigate the pathogenic bacteria distribution and the predictive value of serum,distill-ate soluble intercellular adhesion molecule-1(sICAM-1),procalcitonin(PCT)and C-reactive protein(CRP)in patients with infectious peritonitis on peritoneal dialysis(PD).METHODS A total of 62 patients with infectious peritonitis after PD(as in the study group)and 64 patients without infectious peritonitis after PD(as in the con-trol group)admitted to Jianyang People's Hospital from May 2020 to May 2023 were recruited.The distribution of pathogenic bacteria were analyzed in the study group.The levels of serum,distillate sICAM-1,PCT and CRP were compared between the two groups.And the predictive value of serum,peritoneal fluid sICAM-1,PCT and CRP levels for infectious peritonitis after PD was analyzed.RESULTS A total of 63 strains of pathogenic bacteria were isolated from 62 patients infectious peritonitis after PD,mainly Escherichia coli and Staphylococcus aureus.The levels of serum,distillate sICAM-1,PCT and CRP in the study group were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The area under the curve(AUC)of combined detection of serum levels of sICAM-1,PCT and CRP was higher than that of the single detection for the prediction of infectious peritonitis after PD.And the sensitivity and specificity of the combined de-tection were 88.71%and 92.19%,respectively.The AUC value of combined detection of distillate levels of sI-CAM-1,PCT and CRP for predicting infectious peritonitis after PD was higher than that of single detection,and the sensitivity and specificity of combined detection were 88.71%and 93.75%,respectively.CONCLUSION Esch-erichia coli and Staphylococcus aureus are the main pathogens of infectious peritonitis after PD,and the disease is related to the changes of sICAM-1,PCT and CRP levels,and the combined detection of the three indexes has high predictive value.