Nakao Masatsugu, Yamamoto Izumi, Maruyama Yukio, Nakashima Akio, Matsuo Nanae, Tanno Yudo, Ohkido Ichiro, Ikeda Masato, Yamamoto Hiroyasu, Yokoyama Keitaro, Yokoo Takashi
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Ther Apher Dial. 2016 Feb;20(1):60-5. doi: 10.1111/1744-9987.12372. Epub 2015 Nov 18.
Peritoneal dialysis-associated peritonitis (PD-associated peritonitis) could influence the outcome of PD patients, including technique survival. Although the use of the twin-bag system has decreased the incidence of peritonitis, the effects of biocompatible PD solutions are controversial. Additionally, since both infection-causing microorganisms and antimicrobial therapies have changed over time, the duration of treatment of peritonitis (the duration of peritonitis) seems to have changed. The study included 527 patients who received PD between January 1980 and December 2012 at a single center. We divided patients undergoing PD into three groups according to the type of PD system used, namely single-bag and conventional PD solutions (S+C group, N = 145), twin-bag and conventional PD solutions (T+C group, N = 171) and twin-bag and biocompatible PD solutions (T+B group, N = 211), and analyzed PD-associated peritonitis incidences. Incidences of PD-associated peritonitis (times per patient-months) and peritonitis-free time were 1/59.4, 1/70.6 and 1/103.1, and 52, 97, and 100 months for the S+C, T+C and T+B groups, respectively. The duration of peritonitis, has thus, become dramatically shorter in recent years. Streptococcus sp. were associated with shortest and fungi with longest durations of peritonitis. Staphylococcus sp. and Pseudomonas aeruginosa were predominant in the S+C group. The twin-bag system has made a greater contribution to reductions in PD-associated peritonitis than biocompatible PD solutions. Furthermore, changes in microorganisms, antimicrobial therapies, patient education and improved PD system devices have presumably affected the reduction in the duration of peritonitis.
腹膜透析相关性腹膜炎（PD相关性腹膜炎）会影响PD患者的预后，包括技术存活。尽管双袋系统的使用降低了腹膜炎的发生率，但生物相容性腹膜透析液的效果仍存在争议。此外，由于致病微生物和抗菌治疗都随时间发生了变化，腹膜炎的治疗持续时间（腹膜炎持续时间）似乎也有所改变。该研究纳入了1980年1月至2012年12月在单中心接受腹膜透析的527例患者。我们根据所使用的腹膜透析系统类型将接受腹膜透析的患者分为三组，即单袋与传统腹膜透析液组（S+C组，N = 145）、双袋与传统腹膜透析液组（T+C组，N = 171）和双袋与生物相容性腹膜透析液组（T+B组，N = 211），并分析了PD相关性腹膜炎的发生率。S+C组、T+C组和T+B组的PD相关性腹膜炎发生率（每患者-月次数）分别为1/59.4、1/70.6和1/103.1，无腹膜炎时间分别为52个月、97个月和100个月。因此，近年来腹膜炎的持续时间显著缩短。链球菌属与最短的腹膜炎持续时间相关，而真菌与最长的腹膜炎持续时间相关。葡萄球菌属和铜绿假单胞菌在S+C组中占主导地位。双袋系统对降低PD相关性腹膜炎的贡献大于生物相容性腹膜透析液。此外，微生物、抗菌治疗、患者教育的变化以及腹膜透析系统装置的改进可能影响了腹膜炎持续时间的缩短。
