实用医学杂志 ›› 2021, Vol. 37 ›› Issue (5): 666-670.doi: 10.3969/j.issn.1006⁃5725.2021.05.021

• 医学检查与临床诊断 • 上一篇    下一篇

血清1⁃磷酸鞘氨醇、铁代谢水平诊断腹膜透析相关性腹膜炎发生的价值

司博林， 程慧栋， 李婧， 华琴   

  1. 开封市中心医院1 心内科，2 超声室（河南开封475000）；3 开封市中医院心内科（河南开封475000）

  • 出版日期:2021-03-10 发布日期:2021-03-10
  • 基金资助:

    江苏大学医学临床科技发展基金项目（编号：JLY20120152）

Diagnostic value of serum Sphingosine ⁃ 1⁃ phosphat and iron metabolism in peritoneal dialysis associated peritonitis

SI Bolin，CHENG Huidong，LI Jing，HUA Qin   

  1. Department of Nephrology，the Affiliated Hospital of Jiangsu University，Zhenjiang 212001，China

  • Online:2021-03-10 Published:2021-03-10

摘要：

目的 探讨血清 1⁃磷酸鞘氨醇（S1P）及铁代谢水平与腹膜透析（PD）患者发生腹膜炎的相关性。方法 选择 2016 年 8 月至 2019 年 8 月在我院长期维持性 PD 患者 160 例，根据是否发生腹膜炎分为 PD 相关性腹膜炎患者 34 例（腹膜炎组），PD相关性非腹膜炎患者 126 例（非腹膜炎组），比较两组间血生化指标、S1P 水平及铁代谢指标，评价不同铁代谢组间 PD 患者腹膜炎发生率，分析 PD 相关性腹膜炎发生的 危险因素及血清 CRP、S1P 和 SF 水平对 PD 相关性腹膜炎的诊断价值。结果 腹膜炎组与非腹膜炎组比 较，血清 S1P、总铁结合力（TIBC）水平明显下降，血清 C 反应蛋白（CRP）、血清铁（SI）、转铁蛋白饱和度 （TSAT）水平明显升高（均 P < 0.05）；与铁缺乏组和铁正常组比较，高铁蛋白组 PD 相关性腹膜炎发生率明显升高（P < 0.05）；多因素logistic 分析示CRP、S1P、SF是PD相关性腹膜炎发生的独立危险因素（P < 0.05）。 ROC 曲线示，血清 CRP、S1P 和 SF 水平对 PD 相关性腹膜炎的具有诊断价值（均 P < 0.05）。结论 血清 CRP、S1P、SF可作为PD 相关性腹膜炎患者的特异性生物标志物。

关键词:

Abstract:

Objective To investigate the correlation among serum Sphingosine ⁃1⁃phosphat（S1P），iron metabolism levels and the risk of peritoneal dialysis（PD）associated peritonitis. Methods Retrospective analysis of 160 patients with long ⁃term maintenance PD in our hospital from August 2016 to August 2019 was conducted. According to the occurrence of peritonitis，34 patients with PD ⁃ associated peritonitis were chosen as peritonitis group and 126 patients with PD⁃associated non⁃peritonitis as non⁃peritonitis group. Blood biochemical index，S1P level and iron metabolism index were compared between the two groups，and the incidence of PD associated perito⁃ nitis among different iron metabolites were evaluated. The risk factors of PD⁃associated peritonitis and the diagnos⁃ tic value of serum CRP，S1P and SF levels for PD⁃associated peritonitis were analyzed. Results The serum levels of S1P and total iron Binding force（TIBC）were significantly decreased，and the serum levels of c⁃reactive protein （CRP），serum ferritin（SF）and transferrin saturation（TSAT）were significantly increased in peritonitis group when compared with those in non⁃peritonitis group（All P < 0.05）. Compared with that in iron deficient group and iron normal group，the incidence of PD⁃related peritonitis was significantly increased in ferritin group. Multivariate logistic analysis showed that CRP，S1P and SF were independent risk factors for PD associated peritonitis（P < 0.05）. ROC curve showed that serum CRP，S1P and SF levels were of diagnostic value for PD ⁃ associated peritonitis （All P < 0.05）. Conclusion Serum CRP，S1P and SF can be used as specific bio⁃markers for patients with PD⁃ associated peritonitis.

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