感染与持续性非卧床腹膜透析患者衰弱的关系分析

目的探索感染和持续性非卧床腹膜透析患者衰弱的关系。方法回顾性分析2011年11月-2017年11月于海南医学院第二附属医院接受治疗的164例持续性非卧床腹膜透析患者的临床资料,按照患者随访1年期间是否发生感染分为感染组(n=42)和未感染组(n=122)。于患者入院第二天收集临床资料和实验室指标水平,采用临床衰弱症状学评价量表对患者衰弱情况进评分。对可能影响持续性非卧床腹膜透析患者感染的因素行多因素Logistic回归分析。结果感染组患者C-反应蛋白(C-reactive protein,CRP)指标水平高于未感染组,清蛋白、前清蛋白、单核细胞趋化蛋白-1(Monocyte chemotactic protein 1,MCP-1)指标水平低于未感染组,差异均有统计学意义(P<0.05)。感染组患者衰弱总发生率为78.57%,高于未感染组患者的58.20%,差异有统计学意义(χ2=5.591,P=0.018)。多因素回归分析结果显示,CRP指标水平、MCP-1指标水平、衰弱评分是影响持续性非卧床腹膜透析患者感染的独立危险因素(P<0.05)。结论持续性非卧床腹膜透析患者感染发生率较高,患者发生感染后实验室指标水平变化较大,且患者发生感染与CRP、MCP-1指标水平以及衰弱评分有关。

Analysis of the relationship between infection and debilitation in persistent ambulatory peritoneal dialysis patients

OBJECTIVE To explore the relationship between infection and debilitation in patients with persistent ambulatory peritoneal dialysis. METHODS The clinical data of 164 patients with continuous ambulatory peritoneal dialysis who were treated in the Second Affiliated Hospital of Hainan Medical College from November 2011 to November 2017 were retrospectively analyzed. They were divided into the infection group(n=42) and the uninfected group(n=122) according to whether patients had infection during 1 year follow-up. Clinical data and laboratory indexes were collected on the second day after the patients was admitted to the hospital and the extent of the debilitation was scored by the clinical debilitating scale. Logistic regression was used to analyze the factors correlated to the infection in patients with persistent ambulatory peritoneal dialysis. RESULTS The level of CRP in the infected group were higher than that in the uninfected group, however, the levels of albumin, proalbumin and MCP-1 in the infected group were lower than that in the uninfected group, and the differences between them were significant(P<0.05). The overall incidence of weakness in the infected group was 78.57%, which was higher than that in the uninfected group of 58.20%, and the difference was significant(χ2=5.591, P=0.018). Multivariate regression analysis showed that levels of CRP and MCP-1 and weakness score were the independent risk factors affecting infection in patients with continuous ambulatory peritoneal dialysis(P<0.05). CONCLUSION The incidence of infection in patients with persistent ambulatory peritoneal dialysis was high. The level of laboratory indicators changed after the infection, and the infection of patients was related to levels of CRP and MCP-1 and debilitating score.