中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2015年
4期
241-245
,共5页
王增四%张燕敏%熊飞%李红波%丁艳琼%高义华
王增四%張燕敏%熊飛%李紅波%丁豔瓊%高義華
왕증사%장연민%웅비%리홍파%정염경%고의화
腹膜炎%年龄因素%预后%微生物学
腹膜炎%年齡因素%預後%微生物學
복막염%년령인소%예후%미생물학
Peritonitis%Age factors%Prognosis%Microbiology
目的 比较本中心不同年龄组腹膜透析(腹透)相关性腹膜炎患者病原菌及治疗转归,为腹透相关性腹膜炎的防治和预后判断提供依据.方法 入选2006年1月1日至2013年12月31日在武汉市第一医院腹透中心随访的所有腹透相关性腹膜炎患者,根据发生腹膜炎时的年龄分为年轻组(＜ 65岁)和老年组(≥65岁),比较两组患者病原菌及治疗转归,并对影响治疗结局的危险因素进行相关分析.结果 研究期间258例患者共发生366例次腹膜炎,腹膜炎的发生率为1次/76.8个患者月.老年组患者腹膜炎的发病率明显高于年轻组患者(1次/56.4个患者月比1次/88.7个患者月,P=0.001).革兰阳性菌是两组患者腹膜炎的主要病原菌,革兰阳性菌和革兰阴性菌主要菌种的组成在两组间差异无统计学意义.老年组真菌性腹膜炎的比例明显高于年轻组(9.6％比3.9％,P=0.026).老年组腹膜炎的病死率也明显高于年轻组患者(46.2％比14.0％,P=0.001).多因素回归分析提示,发生腹膜炎时较长透析龄及真菌性腹膜炎是导致腹膜炎患者治疗失败的独立危险因素.结论 老年患者腹膜炎的发病率高,并且真菌性腹膜炎的比例及腹膜炎相关病死率均高于年轻组.
目的 比較本中心不同年齡組腹膜透析(腹透)相關性腹膜炎患者病原菌及治療轉歸,為腹透相關性腹膜炎的防治和預後判斷提供依據.方法 入選2006年1月1日至2013年12月31日在武漢市第一醫院腹透中心隨訪的所有腹透相關性腹膜炎患者,根據髮生腹膜炎時的年齡分為年輕組(＜ 65歲)和老年組(≥65歲),比較兩組患者病原菌及治療轉歸,併對影響治療結跼的危險因素進行相關分析.結果 研究期間258例患者共髮生366例次腹膜炎,腹膜炎的髮生率為1次/76.8箇患者月.老年組患者腹膜炎的髮病率明顯高于年輕組患者(1次/56.4箇患者月比1次/88.7箇患者月,P=0.001).革蘭暘性菌是兩組患者腹膜炎的主要病原菌,革蘭暘性菌和革蘭陰性菌主要菌種的組成在兩組間差異無統計學意義.老年組真菌性腹膜炎的比例明顯高于年輕組(9.6％比3.9％,P=0.026).老年組腹膜炎的病死率也明顯高于年輕組患者(46.2％比14.0％,P=0.001).多因素迴歸分析提示,髮生腹膜炎時較長透析齡及真菌性腹膜炎是導緻腹膜炎患者治療失敗的獨立危險因素.結論 老年患者腹膜炎的髮病率高,併且真菌性腹膜炎的比例及腹膜炎相關病死率均高于年輕組.
목적 비교본중심불동년령조복막투석(복투)상관성복막염환자병원균급치료전귀,위복투상관성복막염적방치화예후판단제공의거.방법 입선2006년1월1일지2013년12월31일재무한시제일의원복투중심수방적소유복투상관성복막염환자,근거발생복막염시적년령분위년경조(＜ 65세)화노년조(≥65세),비교량조환자병원균급치료전귀,병대영향치료결국적위험인소진행상관분석.결과 연구기간258례환자공발생366례차복막염,복막염적발생솔위1차/76.8개환자월.노년조환자복막염적발병솔명현고우년경조환자(1차/56.4개환자월비1차/88.7개환자월,P=0.001).혁란양성균시량조환자복막염적주요병원균,혁란양성균화혁란음성균주요균충적조성재량조간차이무통계학의의.노년조진균성복막염적비례명현고우년경조(9.6％비3.9％,P=0.026).노년조복막염적병사솔야명현고우년경조환자(46.2％비14.0％,P=0.001).다인소회귀분석제시,발생복막염시교장투석령급진균성복막염시도치복막염환자치료실패적독립위험인소.결론 노년환자복막염적발병솔고,병차진균성복막염적비례급복막염상관병사솔균고우년경조.
Objective To provide guide for prevention and cure of peritonitis in peritoneal dialysis(PD) by comparing the causative organisms and clinical outcome of PD related peritonitis in younger and elderly patients in our center.Methods All patients who developed PD related peritonitis between January 2006 and December 2013 in Wuhan NO.1 hospital were included.According to their age,episodes were divided into younger patients group (＜ 65 years) and elderly patients group (≥65 years).The microbiology and clinical outcome of PD related peritonitis were compared,and the related risk factors of the treatment failure were analyzed.Results Three hundred and sixty-six episodes of peritonitis occurred in 258 patients during the study period.The overall rate of peritonitis was 1 episode in 76.8 patient-months.Elderly patients had higher incidence of peritonitis (1 episode every 56.4 months vs 1 episode every 88.7 months,P=0.001),higher incidence of fungus infection (9.6％ vs 3.9％,P=0.026) and higher mortality (46.2％ vs 14.0％,P=0.001) than that in younger patients.Cox regression analysis showed that longer duration of PD treatment and fungal peritonitis were both risk factors of the treatment failure.Conclusion Elderly patients had higher incidence of peritonitis,higher incidence of fungus infection and higher PD-related mortality than younger patients.
