摘要
目的:探讨透析液降钙素原和内毒素对腹膜透析相关性腹膜炎早期诊断和预后警示的研究。方法:研究对象选取笔者所在医院2017年2月-2020年12月诊治的慢性肾衰竭行腹膜透析者63例,按是否发生腹膜炎分为发生腹膜炎47例和非腹膜炎16例。根据临床诊断和腹水培养将47例腹膜炎分为革兰阳性组26例和革兰阴性组21例。比较各组患者降钙素原、内毒素、C反应蛋白、腹透液常规、血常规的水平及治疗前后各指标水平,同时分析腹透析液培养及药敏结果。结果:腹膜炎组的降钙素原、内毒素、C反应蛋白、外周血白细胞、腹透析液白细胞均明显高于非腹膜炎组(P<0.001);革兰阳性组以表皮葡萄球菌(23.08%)为主,革兰阴性组以大肠埃希菌(23.81%)为主,革兰阳性组以万古霉素(92.31%)最为敏感,革兰阴性组以头孢哌酮(90.45%)最敏感;革兰阴性组的内毒素表达水平明显高于革兰阳性组(P<0.001);治疗后的降钙素、内毒素、C反应蛋白、外周血白细胞、腹透析液白细胞均明显低于治疗后(P<0.05)。结论:腹膜透析相关性腹膜炎透析液中降钙素和内毒素呈高表达水平,可作为预测腹膜炎的指标,内毒素可作为预测革兰阴性菌感染的指标。
Objective:To investigate the value of procalcitonin and endotoxin in the early diagnosis and prognosis of peritoneal dialysis associated peritonitis.Method:A total of 63 patients with chronic renal failure who underwent peritoneal dialysis in our hospital from February 2017 to December 2020 were selected and divided into 47 cases of peritonitis and 16 cases of stable non peritonitis.According to the clinical diagnosis and ascites culture,47 cases of peritonitis were divided into the gram positive group of 26 cases and the gram negative group of 21 cases.The levels of procalcitonin,endotoxin,C-reactive protein,peritoneal dialysis fluid routine,blood routine and the levels of each index before and after treatment were compared in each group,and the results of peritoneal dialysis fluid culture and drug sensitivity were analyzed.Result:The levels of calcitonin,endotoxin,C-reactive protein,leukocytes in peripheral blood and peritoneal dialysis fluid in peritonitis group were significantly higher than those in non peritonitis group(P<0.001).Staphylococcus epidermidis(23.08%)was the main of the gram positive group,Escherichia coli(23.81%)was the main of the gram negative group,Vancomycin(92.31%)was the most sensitive of the gram positive group,Cefoperazone(90.45%)was the most sensitive of the gram negative group.The expression level of endotoxin in gram negative group was significantly higher than that in gram positive group(P<0.001).The levels of calcitonin,endotoxin,C-reactive protein,peripheral blood leukocytes and peritoneal dialysis fluid leukocytes after treatment were significantly lower than those before treatment(P<0.05).Conclusion:The expression levels of procalcitonin and endotoxin in peritoneal dialysis associated peritonitis are high,which can be used to predict peritonitis,and endotoxin can be used to predict gram-negative bacterial infection.
作者
黄玉英
彭耀尧
梁晓东
林周徒
HUANG Yuying;PENG Yaoyao;LIANG Xiaodong;LIN Zhoutu(The Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China;不详)
出处
《中外医学研究》
2021年第16期82-85,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
湛江市非资助科技攻关计划项目(2014B01099)。
关键词
降钙素原
内毒素
腹膜透析相关性腹膜炎
Procalcitonin
Endotoxin
Peritoneal dialysis related peritonitis
