目的  分析腹膜透析相关性腹膜炎(pferitoneal dialysis-associated peritonitis，PDAP)患者拔除腹膜透析管的影响因素，构建PDAP患者拔管预测模型，分析影响因子的预测价值。 方法  回顾性分析2016年12月─2024年12月在徐州市第一人民医院规律随访并发生PDAP的患者516例，按照治疗效果分治愈组(n=459)和拔管组(n=57)，采用多因素Logistic回归分析构建PDAP患者拔管风险预测模型，采用ROC曲线分析预测因子的价值。 结果  拔管组透析龄高于治愈组(t=-3.172，P=0.002)，且就诊时间存在延迟(χ²=13.122，P＜0.001)。治愈组残余肾功能保留者多于拔管组(χ²=9.621，P=0.002)，治愈组前白蛋白高于拔管组(χ²=-7.121，P＜0.001)，拔管组全身炎症反应指数(systemic inflammatory response index，SIRI)高于治愈组(Z=-7.635，P＜0.001)。治愈组中革兰氏阳性菌(G+菌)占比高于拔管组(χ²=26.362，P＜0.001)，真菌全部存在于拔管组中(χ²=158.261，P＜0.001)。多因素Logistic回归分析结果显示透析龄(OR=1.008，95% CI：1.001～1.015，P=0.024)，SIRI(OR=1.071，95% CI：1.006～1.139，P＝0.031)，纤维蛋白原(OR=1.249，95% CI：1.026～1.522，P=0.027)与拔管呈正相关，而前白蛋白(OR=0.989，95% CI：0.985～0.993，P=0.010)、24 h内就诊(OR=0.455，95% CI：0.239～0.866，P=0.016)与拔管呈负相关。ROC曲线分析得出SIRI曲线下面积为0.810，界定值为4.845，预测敏感度和特异度分别为0.772、0.719，约登指数最大(0.491)。 结论  拔除腹膜透析导管与PDAP患者的营养、炎症状态、是否及时就诊相关，透析龄、SIRI、纤维蛋白原是拔除腹膜透析管的危险因素。SIRI对于拔除腹膜透析导管具有预测价值，而前白蛋白、24 h内及时就诊则是避免拔管的保护因素。

Objective To analyze the factors influencing catheter removal in patients with peritoneal dialysis‑associated peritonitis (PDAP), to construct a prediction model for catheter removal, and to evaluate the predictive value of these factors. Methods A retrospective analysis was conducted on 516 patients who had regular follow‑up and developed PDAP at Xuzhou First People’s Hospital from December 2016 to December 2024. Patients were divided into a cure group (n=459) and a catheter‑removal group (n=57) according to treatment outcome. Multivariate logistic regression was used to build a risk prediction model for catheter removal, and receiver operating characteristic (ROC) curve analysis was applied to assess the predictive value of the identified factors. Results The dialysis vintage in the catheter‑removal group was significantly longer than that in the cure group (t=-3.172, P=0.002), and the time to presentation was more often delayed (χ²=13.122, P<0.001). More patients in the cure group had preserved residual renal function (χ²=9.621, P=0.002). Prealbumin levels were higher in the cure group (χ²=-7.121, P<0.001), whereas the systemic inflammatory response index (SIRI) was significantly higher in the catheter-removal group (Z=-7.635, P<0.001). Gram-positive bacteria were more frequently isolated in the cure group (χ²=26.362, P<0.001), while all fungal infections occurred exclusively in the catheter‑removal group (χ²=158.261, P<0.001). Multivariate logistic regression showed that dialysis vintage (OR=1.008, 95% CI: 1.001～1.015, P=0.024), SIRI (OR=1.071, 95% CI: 1.006～1.139, P=0.031), and fibrinogen (OR=1.249, 95% CI: 1.026～1.522, P=0.027) were positively associated with catheter removal, whereas prealbumin (OR=0.989, 95% CI: 0.985～0.993, P=0.010) and presentation within 24 hours (OR=0.455, 95% CI: 0.239～0.866, P=0.016) were protective factors. ROC curve analysis yielded an area under the curve (AUC) of 0.810 for SIRI, with a cutoff value of 4.845, sensitivity of 0.772, specificity of 0.719, and the maximum Youden index (0.491). Conclusion Catheter removal in PDAP patients is associated with nutritional status, inflammatory state, and timely presentation. Dialysis vintage, SIRI, and fibrinogen are risk factors for catheter removal. SIRI has good predictive value for catheter removal, whereas prealbumin and presentation within 24 hours are protective factors against removal.