慢性肾功能衰竭患者腹膜透析期间腹腔感染的影响因素分析

Influencing factors for abdominal infection in patients with chronic renal failure during peritoneal dialysis

目的分析慢性肾功能衰竭患者腹膜透析期间腹腔感染的影响因素。方法回顾性分析2015年1月-2017年12月医院收治的慢性肾功能衰竭腹膜透析患者460例,其中腹腔感染35例为感染组,其余425例为非感染组。记录患者性别、年龄、体质量指数及是否合并糖尿病等基础信息;统计患者腹膜透析病程,即透析龄(月);对患者进行APACHEII评分;抽取两组患者静脉血检测生化指标(白细胞、血红蛋白、C-反应蛋白、血浆白蛋白及血浆前白蛋白)。结果两组患者年龄、性别、BMI相比无差异,感染组合并糖尿病的比例、APACHEII评分及透析龄均明显高于非感染组(P<0.05)。感染组血白细胞计数大于非感染组,C-反应蛋白和血红蛋白量与非感染组比较无显著差异,血浆白蛋白及血浆前白蛋白均明显低于非感染组(P<0.001)。单因素和多因素logistic回归分析,显示合并糖尿病、APACHEⅡ评分、透析龄、血浆白蛋白及血浆前白蛋白是腹腔感染的影响因素(P<0.05)。结论慢性肾功能衰竭腹膜透析期间腹腔感染的影响因素有多种,合并糖尿病、APACHEII评分高、透析龄长及低蛋白血症是该类患者腹腔感染的影响因素。

OBJECTIVE To investigate the influencing factors for abdominal infection in patients with chronic renal failure during peritoneal dialysis.METHODS A total of 460 patients with chronic renal failure who received peritoneal dialysis from Jan 2015 to Dec 2017 were retrospectively analyzed,35 patients who had abdominal infection were assigned as the infection group,and the rest of 425 patients were set as the non-infection group.The baseline data of the patients,including gender,age,body mass index and complication with diabetes mellitus,were recorded,the course of peritoneal dialysis,known as the dialysis age(month),was statistically analyzed,the APACHEII score of the patients was analyzed,and the venous blood specimens were drawn from the two groups of patients so as to detect the biochemical indexes(white blood cell,hemoglobin,C-reactive protein,plasma albumin and prealbumin).RESULTS There were no significant differences in the age,gender and BMI between the two groups of patients.The proportion of the patients complicated with diabetes mellitus,APACHEII score and dialysis age of the infection group were sighificantly greater than those of the non-infection group(P<0.05).The white blood cell counts of the infection group were greater than those of the non-infection group;there were no significant differences in the levels of C-reactive protein and hemoglobin between the infection group and the noninfection group;the levels of plasma albumin and prealbumin of the infection group were sighificantly lower than those of the non-infection group(P<0.001).The univariate analysis and multivariate logistic regression analysis showed that complication with diabetes mellitus,APACHEⅡscore,dialysis age,plasma albumin and prealbumin were the influencing factors for the abdominal infection(P<0.05).CONCLUSION There are a variety of influencing factors for the abdominal infection in the patients with chronic renal failure during peritoneal dialysis.The complication with diabetes mellitus,high APACHEII score,long-term dialysis and hypoproteinemia are the influencing factors for the abdominal infection.