【摘要】目的探讨腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis，PDAP)预后不良的独立危险因素。方法回顾性分析2015 年2 月～2021 年1 月北京大学第三医院肾脏内科腹膜透析患者PDAP 时的资料。结果本研究纳入的142 例次PDAP 中治愈100 例，复发19 例，退出(拔管/死亡)23 例。Logistic 回归显示，血白细胞计数(OR=1.195，95% CI1.024～1.394，P=0.024)、血白蛋白(OR=0.878，95% CI 0.787～0.979，P=0.019)是退出(拔管/死亡)腹膜透析的独立影响因素。和培养阴性相比，致病菌为球菌的PDAP 预后更好(OR=0.113，95% CI 0.013～1.012，P=0.051)。治愈的患者中就诊时间延迟(就诊时间＞48h)者缓解天数长于及时就诊(就诊时间＜24h)者(Z=17.849，P＜0.001)。结论血白细胞计数和血白蛋白是PDAP患者技术失败的独立影响因素，延迟就诊延长病程。
【Abstract】Objective To investigate the independent risk factors for poor prognosis of peritoneal dialysis-associated peritonitis (PDAP). Methods The data of peritoneal dialysis (PD) patients from February 2015 to January 2021 in our department were retrospectively analyzed. Results Among the 142 cases of PDAP in this study, 100 cases cured, 19 cases relapsed, and 23 cases withdrew the treatment (extubation/death). Logistic regression showed that white blood cell count (OR=1.195, P=0.024) and serum albumin (OR=0.878, P=0.019) were the independent influencing factors for withdrawal (extubation/death) from PD (P<0.05). Compared with the PDAP patients of negative bacterial culture, those of pathogenic cocci bacteria had a better prognosis (OR=0.113, P=0.051). Among the cured patients, the remission days were longer in those with delayed treatment (>48h) than in those with earlier treatment (<24h) (Z=17.849, P<0.001). Conclusion The white blood cell count and serum albumin are the independent influencing factors for technical failure in PDAP patients. Delayed treatment prolongs the disease course.
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