【摘要】目的明确腹膜透析相关性腹膜损伤CT 影像学特征变化规律及影响因素。方法选择陆军军医大学大坪医院特色医学中心肾内科腹膜透析中心规律随访的持续性非卧床腹膜透析的患者173 例行全腹部CT 扫描，对符合入排标准的109 例患者评估腹膜损伤，并分析腹腔CT 影像学评价指标与年龄、透析龄、原发病、腹膜转运类型、糖暴露量、腹膜炎次数等临床指标的关系。Logistic 回归方法分析腹膜增厚及网膜结构异常的影响因素、腹膜炎次数与腹膜增厚及网膜结构异常发生风险的关系。结果腹部CT 扫描109 例患者发现壁层腹膜增厚70 例(64.22%)，网膜结构异常63 例(57.8%)。Logistic 回归分析显示：腹膜炎发生次数及腹膜炎累积评分是腹膜增厚及网膜结构异常独立危险因素。风险预测模型提示：每发生1 次腹膜炎，腹膜增厚发生风险增加4.364 倍(OR=4.364，95% CI:1.886～10.098)，网膜结构异常发生风险增加5.393 倍(OR=5.393，95% CI:2.204～13.197)。结论腹膜透析患者壁层腹膜增厚和网膜结构改变是腹膜进行性损伤影像学主要特征，腹膜炎是导致腹膜进行性损伤的主要危险因素。腹腔CT 检查可以全面了解腹膜透析腹膜损伤的特征和程度，有助于早期诊断腹膜损伤。
杨杰
,
肖菲
,
陈佳
,
侯世会
,
王毅
,
张伟国
,
龚文姜
,
余艳
,
蔡明玉
,
何娅妮
. 腹膜透析相关性腹膜损伤CT 影像学特征变化规律及影响因素的研究[J]. 中国血液净化, 2019
, 18(12)
: 809
-813
.
DOI: 10.3969/j.issn.1671-4091.2019.12.001
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