中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (02): 81-84.doi: 10.3969/j.issn.1671-4091.2020.02.003

• 临床研究 • 上一篇    下一篇

基线血尿酸水平与首次腹膜透析相关性腹膜炎间的关系

李庆根1,刘桂凌1,詹秋楠1,方味味1,荣新1,陈晓莉1   

  1. 1. 安徽医科大学第二附属医院肾脏内科
  • 收稿日期:2019-08-26 修回日期:2019-12-04 出版日期:2020-02-20 发布日期:2020-02-12
  • 通讯作者: 刘桂凌 guilingliu369@163.com E-mail:guilingliu369@163.com
  • 基金资助:
    安徽省卫计委适宜技术推广项目，2018-TG04

Relationship between baseline uric acid level and primary peritoneal dialysis- associated peritonitis

  1. 1Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
  • Received:2019-08-26 Revised:2019-12-04 Online:2020-02-20 Published:2020-02-12

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摘要： 【摘要】目的探讨维持性腹膜透析患者基线血尿酸水平与首次腹膜透析相关性腹膜炎(以下简称“腹膜炎”)间的关系。方法选取2012 年1 月～2018 年1 月在安徽医科大学第二附属医院肾脏内科新进入腹膜透析且能长期规律随访的腹膜透析患者130 例，分为首次腹膜炎组和非腹膜炎组，分析两组患者基线血尿酸水平、有关实验室指标间的关系及基线血尿酸水平对首次腹膜炎的预测价值。结果130例患者中首次腹膜炎占37.3%，与非腹膜炎组患者相比，首次腹膜炎组年龄较小(t=1.664，P=0.020)，基线血尿酸、血磷水平较高(t 值分别为-6.367，-3.691；P 值分别为＜0.001，P＜0.001)，血红蛋白(hemoglobin,HGB)较低(t=2.388，P=0.018)。首次腹膜炎与基线血尿酸、血磷呈正相关(r 值分别为0.487，0.310；P 值分别为＜0.001，＜0.001)，与HGB 呈负相关(r=-0.206，P=0.018)。单因素Logistics 回归分析结果显示基线高血尿酸、低HGB 是首次腹膜炎发生的危险因素(OR 值分别为1.013，0.968；95% CI 值分别为1.007～1.018，0.938～1.000；P 值分别为＜0.001, 0.047)。多因素分析显示基线高血尿酸、低血白蛋白、合并有糖尿病是首次腹膜炎发生的危险因素(OR 值分别为1.014，0.909，3.808； 95% CI 值分别为1.008～1.019，0.840～0.985，1.180～12.288；P 值分别为＜0.001,0.020,0.006)。结论维持性腹膜透析患者的基线血尿酸水平与腹膜透析后发生的首次腹膜炎显著相关；腹膜透析治疗的终末期肾病患者，腹膜透析置管前基线血尿酸水平越高，越容易发生腹膜炎。

关键词: 感染, 腹膜透析相关性腹膜炎, 尿酸, 腹膜透析

Abstract: 【Abstract】Objective To investigate the relationship between baseline serum uric acid level and primary peritoneal dialysis-associated peritonitis. Methods Peritoneal dialysis (PD) patients admitted to the Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University for the first time between January 2012 and January 2018 and followed up regularly for a long period of time were recruited in this study. Patients were divided into primary peritonitis group and non- peritonitis group. The relationship between baseline serum uric acid level and other related laboratory indexes was analyzed in the two groups. The
level of baseline serum uric acid for the prediction of primary PD-associated peritonitis was evaluated. Results Primary peritonitis occurred in 37.3% of the 130 PD patients. Patients in primary peritonitis group had younger age (t=1.664, P=0.020), higher levels of baseline serum uric acid (t=-6.367, P<0.001) and phosphorus (t=-3.691, P<0.001) and lower hemoglobin (t=2.388, P=0.018), as compared with those in non-peritonitis group. Primary PD- associated peritonitis was positively correlated with baseline levels of serum uric acid(r=0.487, P<0.001) and serum phosphorus (r=0.310, P<0.001), and negatively correlated with hemoglobin(r=-0.206, P=0.018). Univariate regression analysis showed that higher baseline serum uric acid (OR=1.013,
95% CI=1.007~1.018, P<0.001) and lower HGB (OR=0.968, 95% CI=0.938~1.000, P=0.047) were the risk factors for primary PD-associated peritonitis. Multivariate analysis showed that higher baseline serum uric acid (OR=1.014, 95% CI=1.008~ 1.019, P<0.001) lower albumin (OR=0.909, 95% CI= 0.840~0.985, P=0.020) and diabetes (OR=3.808, 95% CI=1.180~ 12.288, P=0.006) were the risk factors for primary PD-associated peritonitis. Conclusions Baseline serum uric acid level was significantly correlated with primary PD-associated peritonitis in continuous PD patients. For end-stage renal disease patients treated with PD, higher baseline serum uric acid level before PD catheterization will be more likely to complicate with primary PD-associated peritonitis.

Key words: Infection, Uric acid, Peritoneal dialysis, Peritoneal dialysis-associated peritonitis

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