腹膜透析相关腹膜炎患者血清和透出液降钙素原检测的研究

    Determination of procalcitonin in serum and ascites of patients with dialysis-related peritonitis

    • 摘要: 目的 探讨腹膜透析(peritoneal dialysis,PD)相关腹膜炎患者血清降钙素原(procalcitonin,PCT)和腹水透出液PCT检测的临床意义,为腹膜透析相关腹膜炎的早期诊断提供参考依据。方法 选取广西桂平市人民医院2014年6月至2017年2月行腹膜透析患者124例并进行分组,其中腹膜透析相关腹膜炎组(A组)63例(其中两次感染者12例,可疑感染18例),非腹膜炎组(B组)61例,检测抗感染治疗前后血清PCT、腹水透出液白细胞(WBC)计数及腹水透出液PCT等指标。同期选取健康体检人员62例(C组)作为对照。结果 A组抗感染治疗前血清PCT水平明显高于B组和C组,腹水透出液WBC计数及PCT水平亦明显高于B组(均P<0.01),差异有极显著性。治疗后A、B、C三组血清PCT差异无显著性(P>0.05),A组腹水透出液WBC计数及PCT水平与B组比较差异均无显著性(均P>0.05)。两次感染者血清PCT及腹水透出液PCT水平差异均无显著性(均P>0.05)。可疑感染组与感染组比较,血清PCT及腹水透出液PCT水平差异无显著性(P>0.05),但其均高于B组,差异有极显著性(P<0.01)。可疑感染组与B组透出液WBC计数差异无显著性(P>0.05),但其均低于感染组,差异有极显著性(P<0.01)。结论 腹膜透析相关腹膜炎患者的血清和腹水透出液PCT水平有明显升高趋势,对腹膜透析相关腹膜炎的早期判断有一定的帮助,具有早期诊断价值和无创性操作等优点,同时也可用来评价临床治疗效果,值得临床推广应用。

       

      Abstract: Objective To investigate the levels of procalcitonin (PCT) in serum as well as pritoneal diadysate in patients with peritoneal dialysis-related peritonitis. Methods 124 patients undergoing peritoneal dialysis and 62 healthy subjects were enrolled in this study from June 2014 to February 2017. In patients given peritoneal dialysis, there were 63 patients with peritoneal dialysis-related peritonitis and 61 patients with non-peritoneitis. The levels of PCT in serum and ascites were determined by electrochemiluminescence immunoassay. The white blood cell (WBC) counts and PCT levels in ascites were detected in patients receiving peritoneal dialysis. Results Before treatment, the levels of serum PCT were significantly higher in peritonitis group than those in non-peritonitis group or healthy group (P<0.01). In pritoneal diadysate, the levels of PCT and the WBC counts were significantly increased in peritonitis group than those in non-peritonitis group (P<0.01). There were no significant differences in serum PCT among the three groups after treatment (P>0.05). In pritoneal diadysate, the levels of PCT and the WBC counts showed no significant difference between peritonitis group and non-peritonitis group after treatment (P>0.05). Conclusions The PCT levels in serum and ascites are significantly increased in patients with peritoneal dialysis-related peritonitis. The PCT can be used as a predictive factor in patients with peritoneal dialysis-related peritonitis.

       

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