腹膜透析中腹膜炎发病率统计方法的评估

目的 评估腹膜透析(腹透)中腹膜炎发病率的统计方法。方法 回顾性的分析仁济医院腹透中心1999年8月1日至2004年6月30日之间使用双联系统的腹透患者腹膜炎发病率,分别采用队列特异性腹膜炎发病率、负二项分布模型、腹膜炎发病率的中位数和无腹膜炎的生存率等方法进行统计。结果队列特异性腹膜炎发病率为1／56.14患者月,负二项分布模型统计的腹膜炎发病率为1／49.58患者月,腹膜炎发病率的中位数为0,平均无腹膜炎的生存时间为39.71月。无腹膜炎生存时间与个体特异性腹膜炎发病率负相关(P<0.05)。结论 队列特异性腹膜炎发病率能描述一个腹透中心的腹膜炎发病率,便于各中心之间进行比较。负二项分布模型能反映患者腹膜炎发病频数的分布趋势,有助于发现高危人群和高危因素,并加强预防。腹膜炎发病率的中位数可用于腹膜炎发生人数超过50％的腹透中心,无腹膜炎生存率能预示腹膜炎的易感性,适用于规模较大的腹透中心评估腹膜炎发病率。综合使用这些方法能更真实的描述腹膜炎发病情况,为针对性的预防腹膜炎提供科学依据。

Assessment of statistical methods of peritonitis rate in peritoneal dialysis

Objective To assess peritonitis rate in peritoneal dialysis. Methods The peritonitis rate from 1999 Aug. 1st to 2004 Jun 30th in Renji Peritoneal Dialysis Center was analyzed retrospectively. Various methods including cohort-specific peritonitis incidence, negative binomial distribution model, median subject-specific peritonitis incidence and peritonitis-free survival were used for the analysis. Results Cohort-specific peritonitis incidence was 1756. 14 patient-month, the mean peritonitis rate estimated using the negative binomial model was 1/49.58 patient-month, median subject-specific peritonitis rate was 0, mean peritonitis-free survival time was 39. 71 months, the peritonitis-free time was inversely correlated with subject-specific peritonitis rate(P <0. 05) .Conclusions Cohort-specific peritonitis incidence can be used for evaluating the peritonitis dialysis rate of a peritoneal dialysis center and comparing between different centers. Negative binomial model can describe the distribution tendency; it is benefit to figure out the high risk population and the risk factors, then to reinforce prevention. Median subject-specific peritonitis incidence is able to be applied in the center that peritonitis occurs more than 50% of patients. Peritonitis-free survival can identify the predisposition to frequent peritonitis of the patients. By useing these methods, the peritonitis rate can be described more effectively in peritoneal dialysis patients, which provide scientific bases for preventing peritonitis in clinical work.