目的 导管出口感染(exit-site infection,ESI)可增加腹膜炎和技术失败风险。本研究分析了外周血嗜酸性粒细胞计数(eosinophils count,EC)与ESI的相关性。 方法 回顾性收集2016年1月─2021年12月在苏州大学附属第二医院腹膜透析中心规律随访的345例患者临床资料，据置管术后3个月外周血EC[中位数180.0(110.0,310.0)/μl]三分位数将患者分为低EC3M组(EC＜130/μl，n=110)，中EC3M组(EC=130～240/μl，n=115)，高EC3M组(EC≥240/μl，n=120)，采用COX比例风险模型分析EC与ESI、死亡、技术失败、PD相关腹膜炎等结局的关系。 结果 患者平均年龄(56.1±15.8)岁，中位随访时间38(29,46)月。Kaplan-Meier曲线经Logrank检验显示高、中、低EC3M组ESI风险存在显著差异(χ2=11.648，P=0.003)。事后成对比较，中EC3M组和高EC3M组ESI风险显著高于低EC3M组(χ²=4.313、11.939，P=0.038、＜0.001)。多因素COX分析校正混杂因素后，手术后3个月EC与ESI独立相关(HR=2.028，95%CI：1.060～3.881，P=0.033)。 结论 PD置管术后3个月EC升高与ESI发生显著关联，监测EC可能提供早期识别ESI高危人群的生物学线索。
Abstract
Objective Exit-site infection (ESI) can increase the risk of peritonitis and technical failure. This study analyzes the correlation between peripheral blood eosinophil count(EC) and ESI. Methods Clinical data of 345 PD patients was retrospectively collected from January 2016 to December 2021. Patients were groups by tertiles of the EC at 3 months of peritoneal dialysis catheter: low EC3M group (EC＜130cells/μL, n=110), mid EC3M group (EC=130-240cells/μL, n=115), and high EC3M group (EC≥240cells/μL, n=120). The relationship between eosinophil count and ESI, all-cause mortality, technique failure, and PD-related peritonitis was analyzed using a multifactorial COX model after adjusting for confounding factors. Results The age of the patients was (56.1±15.8) years old. The median follow-up duration was 38(29,46) months. The Kaplan-Meier survival curves with the log-rank test showed that there were significant differences in the risk of ESI incidence among the high, medium, and low EC3M groups (χ²=11.648, P=0.003). Post-hoc pairwise comparisons revealed that the medium EC3M group (χ²=4.313, P=0.038) and the high EC3M group (χ²=11.939, P＜0.001) had significantly higher ESI risks compared to the low EC3M group. Multivariate COX analysis revealed that after adjusting for confounding factors, the EC at three months after the operation was independently associated with ESI (HR=2.028, 95%CI 1.060-3.881, P=0.033). Conclusion Elevated peripheral eosinophil counts at 3 months post-PD catheterization are independently associated with ESI. Monitoring EC may aid in early identification of high-risk ESI patients.
关键词
腹膜透析 /
出口感染 /
嗜酸粒细胞计数 /
死亡 /
腹膜炎
Key words
Peritoneal dialysis /
Exit-site infection /
Eosinophils count /
Death /
Peritonitis
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