目的 探讨控制营养状况(controlling nutritional status，CONUT)评分对腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis，PDAP)患者治疗预后的预测价值。 方法 根据治疗效果把161例确诊为PDAP的患者分为治愈组和治疗失败组，对2组患者的临床资料进行统计学比较。使用Logistic回归分析CONUT评分与治疗效果的关联强度，应用受试者工作特征(ROC)曲线分析CONUT评分对PDAP患者治疗预后的预测价值。 结果 治疗失败组的透析龄(Z=-3.027，P=0.002)、超敏C反应蛋白(hs-CRP)(Z=-2.608，P=0.009)、CONUT评分(Z=-3.161，P=0.002)高于治愈组，白蛋白(t=2.158，P=0.032)低于治愈组。单因素回归分析显示透析龄(OR=1.025，95% CI： 1.011～1.039，P=0.001)、hs-CRP(OR=1.006，95% CI：1.000～1.011，P=0.038)、白蛋白(OR=0.906，95% CI： 0.827～0.933，P=0.035)、CONUT评分(OR=1.529，95% CI：1.150～2.039，P=0.004)是PDAP患者不良预后的危险因素；多因素回归显示透析龄(OR=1.024，95% CI：1.008～1.039，P=0.002)、CONUT评分(OR=1.613，95% CI：1.058～2.459， P=0.026)是PDAP患者不良预后的独立危险因素。透析龄联合CONUT评分的曲线下面积最大，为0.802(95% CI：0.580～0.882，P＜0.001)。结论 较长的透析龄、较高的CONUT评分是PDAP患者不良预后的独立危险因素，且二者联合CONUT评分对PDAP患者预后有着较高的预测价值。
Objective To investigate the predictive value of the controlling nutrition status (CONUT) score for the prognosis of peritoneal dialysis-associated peritonitis (PDAP) after treatment. Method A total of 161 patients with PDAP were divided into a cured group and a treatment failure group base on their treatment effect. Their clinical data were compared. Logistic regression was used to analyze the correlation between CONUT score and treatment effect. ROC curve was used to analyze the predictive value of CONUT score on prognosis of the patients after treatment. Result Dialysis age (Z=-3.027, P=0.002), hs-CRP (Z=-2.608, P=009) and CONUT score (Z=-3.161, P=0.002) were higher and albumin (t=2.158, P=0.032) was lower in the treatment failure group as compare with those in the cured group. Univariate logistic regression showed that dialysis age (OR=1.025, 95% CI: 1.011～1.039, P=0.001), hs-CRP (OR=1.006, 95% CI:1.000～1.011, P=0.038), albumin (OR=0.906, 95% CI: 0.827～0.933, P=0.035) and CONUT score (OR=1.529, 95% CI: 1.150～2.039, P=0.004) were the risk factors for poor prognosis of PDAP. Multivariate logistic regression showed that dialysis age (OR=1.024, 95% CI: 1.008～1.039, P=0.002) and CONUT score (OR=1.613, 95% CI:1.058～2.459, P=0.026) were the independent risk factors for poor prognosis of PDAP. ROC curve showed that dialysis age (months) combined with CONUT score had the greatest predictive value for the prognosis of PDAP, and the area under the curve was 0.802 (95% CI: 0.682～0.921, P<0.001). Conclusion Longer dialysis age (months) and higher CONUT score are the independent risk factors for poor prognosis of PDAP. Dialysis age (months) combined with CONUT score is highly predictive for the prognosis of PDAP patients after treatment.
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