摘要
目的分析腹膜透析相关性腹膜炎患者外周血基质金属蛋白酶抑制因子-1(TIMP-1)、基质金属蛋白酶抑制因子-2(TIMP-2)和转铁蛋白饱和度(TSAT)水平与临床转归的关系。方法选取2021年8月至2023年2月收治的100例腹膜透析相关性腹膜炎患者,根据患者拔除腹膜透析管后1年内临床转归情况将其分为治愈组(n=68)和恶化组(n=32)。比较2组临床资料及外周血TIMP-1、TIMP-2及TSAT水平,采用多因素Logistic回归分析影响腹膜透析相关性腹膜炎患者病情恶化的独立危险因素,采用受试者工作特征(ROC)曲线分析TIMP-1、TIMP-2及TSAT对患者临床转归的预测价值。结果恶化组透析龄高于治愈组,有腹膜炎病史患者占比大于治愈组,TIMP-1、TIMP-2和TSAT水平低于治愈组(P<0.01)。TIMP-1、TIMP-2和TSAT水平过低均是腹膜透析相关性腹膜炎患者病情恶化的独立危险因素(P<0.05)。ROC曲线分析显示,TIMP-1、TIMP-2和TSAT预测腹膜透析相关性腹膜炎患者临床转归的曲线下面积(AUC)分别为0.759、0.702和0.739,上述指标联合检测的AUC为0.813,具有更好的预测价值(P<0.05)。结论病情恶化的腹膜透析相关性腹膜炎患者TIMP-1、TIMP-2和TSAT水平降低,且三者及其联合检测对患者临床转归均有较高的预测价值。
Objective To analyze the levels of tissue inhibitor of metalloproteinase-1(TIMP-1),tissue inhibitor of metalloproteinase-2(TIMP-2)and transferrin saturation(TSAT)in peripheral blood of peritoneal dialysis-associated peritonitis(PDAP)patients and their relationship with clinical outcomes.Methods A total of 100 patients with PDAP admitted from August 2021 to February 2023 were selected and divided into cure group(n=68)and worsening group(n=32)according to their clinical outcomes within 1 year after removal of peritoneal dialysis tube.The clinical data and peripheral blood TIMP-1,TIMP-2 and TSAT levels were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the independent risk factors for the deterioration of PDAP in those patients.The predictive value of TIMP-1,TIMP-2 and TSAT for clinical outcome of patients was analyzed by receiver operating characteristic(ROC)curve.Results The dialysis age in the worsening group was higher than that in the cure group,the proportion of patients with history of peritonitis was higher than that in the cure group,and the TIMP-1,TIMP-2 and TSAT levels were lower than those in the cure group(P<0.01).Low levels of TIMP-1,TIMP-2 and TSAT were independent risk factors for deterioration of PDAP in those patients(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC)of TIMP-1,TIMP-2 and TSAT in predicting the clinical outcome of PDAP patients were 0.759,0.702 and 0.739,respectively,and that the AUC of the combined detection of the above indicators was 0.813,which had better predictive value(P<0.05).Conclusion TIMP-1,TIMP-2 and TSAT levels were reduced in PDAP patients with worsening disease,and the three factors detected alone and in combination had high predictive value for clinical outcomes of patients.
作者
李雅琪
郭宝珠
程锦绣
金玉杰
LI Yaqi;GUO Baozhu;CHENG Jinxiu;JIN Yujie(Department of Chronic Disease Management,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Nephrology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《临床误诊误治》
CAS
2024年第13期40-44,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省卫生健康委员会医学科学研究项目(20231411)。
