维持性腹膜透析患者铁负荷与腹膜炎相关性的临床研究

Clinical study on the correlation between iron load and peritonitis in patients with maintenance peritoneal dialysis

目的:探讨维持性腹膜透析患者铁负荷与腹膜炎相关性。方法:将100例腹膜透析的终末期肾病患者按基线血清铁蛋白(SF)水平分为A组(铁负荷升高组,SF>500 mg/L,n=40)和B组(铁负荷正常组,SF≤500 mg/L,n=60)。对比2组实验室指标、腹膜平衡试验及残余肾小球滤过率、腹膜炎发生率,并分析腹膜炎发生与各指标之间的相关性。结果:A组SF、C反应蛋白(CRP)、血清铁(SI)、总铁结合力(TIBC)、转铁蛋白饱和度(TSAT)、腹膜炎发生率高于B组,不饱和铁结合力(UIBC)、D/P低于B组(P<0.05);腹膜炎组SF、CRP、SI、TSAT水平高于非腹膜炎组,TIBC、UIBC低于非腹膜炎组(P<0.05);腹膜炎发生与SF、CRP水平呈正相关(P<0.05)。结论:维持性腹膜透析患者铁负荷、CRP水平与腹膜炎发生密切相关,临床可从调整铁代谢水平入手实施干预,减少腹膜炎发生。

Objective:To investigate the correlation between iron load and peritonitis in the patients with maintenance peritoneal dialysis.Methods:One hundred end-stage renal disease patients with peritoneal dialysis were divided into group A(elevated iron load,SF>500 mg/L,n=40)and group B(normal iron load,SF≤500 mg/L,n=60)according to baseline serum ferritin(SF)levels.Laboratory indexes,peritoneal balance test,residual glomerular filtration rate and peritonitis incidence were compared between the two groups,and the correlation between peritonitis incidence and each index was analyzed.Results:SF,C-reactive protein(CRP),serum iron(SI),total iron binding capacity(TIBC),transferrin saturation(TSAT)and peritonitis incidence were higher and unsaturated iron binding capacity(UIBC)and D/P were lower in group A than the group B(P<0.05).SF,CRP,SI,and TSAT levels were higher and TIBC and UIBC levels were lower in the peritonitis group than the non-peritonitis group(P<0.05).The occurrence of peritonitis was positively correlated with SF and CRP levels(P<0.05).Conclusion:Iron load and CRP levels in the patients with maintenance peritoneal dialysis are closely related to the occurrence of peritonitis,and clinical intervention can be carried out by adjusting iron metabolism levels to reduce the occurrence of peritonitis.