【摘要】目的探讨南方沿海地区的季节变化特点对腹膜透析相关性腹膜炎的影响。方法回顾性分析2014 年1 月～2020 年12 月入院治疗的腹膜炎患者的一般资料和疾病相关资料，按照腹膜炎发生的季节将患者分组，比较组间腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis, PDAP)的发生率以及腹膜炎发生率与月平均温度、湿度和降水量的相关关系。比较各致病菌所致的腹膜炎的构成比在季节间的差异。结果178例患者共发生腹膜透析相关性腹膜炎323例次，平均发生率为0.24 次/风险年。将患者按照发生季节分组后，对比发现，腹膜透析相关性腹膜炎的发生率无季节差异(χ2=0.019, P=0.995)，与月平均温度(r=0.226, P= 0.479)、月平均湿度(r=-0.180, P=0.576)以及月平均降水量(r=0.070, P=0.828)之间均不存在相关性。PDAP 的致病菌中，G+菌所致的腹膜炎占比最高(51.4%)，且在夏季发生率更高，G-菌所致的腹膜炎秋季发生率较高，但各类致病菌的构成比不存在季节差异(χ2= 19.004, P=0.088)。结论南方沿海地区腹膜透析相关性腹膜炎的发生率无季节差异；与月平均气温、湿度和降水量无相关性；致病菌无季节差异。未来可深入研究，探讨导致腹膜炎的主要影响因素。
【Abstract】Objectives To explore the effects of seasonal changes on peritoneal dialysis-associated peritonitis (PDAP) in the coastal area of southern China. Methods A retrospective analysis was conducted in the PDAP patients treated during 1st January, 2014 to 31st December, 2020. They were divided into four groups based on the four seasons. OnEway ANOVA and chi square test were used to compare the incidence of PDAP and clinical indexes among the four groups. Pearson correlation analysis was used to analyze the relationship between the incidence of PDAP and climate factors, including monthly mean temperature, humidity and rainfall in the coastal area of southern China. The pathogens of PDAP were also compared among the four groups. Results A total of 323 PDAP episodes in the 178 patients (0.24 episodes/risk year) were recorded during the follow-up period of 6 years. There was no significant difference in the incidence of PDAP among the four groups (χ2=0.019, P=0.995). The incidence of PDAP also had no correlations with monthly mean temperature (r=0.226，P=0.479), monthly mean humidity (r=- 0.180, P=0.576), and monthly mean rainfall (r=0.070, P=0.828). Gram-positive bacteria caused more than half (51.4%) of the PDAP, especially in summer. Gramnegative bacteria were found higher in PDAP in autumn than in other seasons. However, the component of
bacterial pathogens was similar among the four groups (χ2=19.004, P=0.088). Conclusion The incidence of PDAP had no correlations with the four seasons, monthly mean temperature, monthly mean humidity and monthly mean rainfall, and the bacterial pathogens of PDAP also had no correlations with the four seasons in CAPD patients in the coastal area of southern China. More investigations are required to explore the risk factors for PDAP.
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