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投稿时间：2024-07-19 网络发布日期：2025-08-20
投稿时间：2024-07-19 网络发布日期：2025-08-20
中文摘要: 目的 分析控制营养状况（CONUT）评分联合透出液可溶性细胞间黏附分子-1（sICAM-1）在腹膜透析相关性腹膜炎（PDAP）患者预后预测中的作用。方法 选取2018年1月至2023年12月于广西中医药大学第一附属医院接受腹膜透析治疗的 176 例 PDAP 患者。入院后，收集所有患者的临床资料及 CONUT 评分、透出液sICAM-1水平。随访3个月，评估患者的预后情况，并将其分为预后不良组（n=60）与预后良好组（n=116）。对比两组患者的临床资料及CONUT评分、透出液sICAM-1水平，采用多因素logistic回归模型分析影响PDAP患者预后的相关因素；采用Pearson法分析CONUT评分与透出液sICAM-1的相关性；采用受试者工作者特征（ROC）曲线分析 CONUT 评分联合透出液 sICAM-1水平预测PDAP患者预后的价值。结果 176例PDAP患者中，共60例（34.09%）预后不良。多因素logistic回归分析结果显示，透析时间长、血清超敏C-反应蛋白（hs-CRP）水平高、血清白蛋白水平低、CONUT评分高、透出液sICAM-1水平高为导致PDAP患者预后不良的独立危险因素（P＜0.05）。Pearson相关分析结果显示，CONUT评分与透出液sICAM-1呈正相关（r=0.657，P＜0.05）。ROC曲线分析结果显示，CONUT评分为12分、透出液sICAM-1为8.62 ng/mL时的曲线下面积（AUC）较大，分别为0.819和0.778，二者联合的AUC为0.847。结论 CONUT评分联合透出液sICAM-1可有效预测PDAP患者的预后，临床应用价值较高。透析时间长、血清hs-CRP水平高、白蛋白水平低、CONUT评分高、透出液sICAM-1水平高均可能导致患者预后不良。
中文关键词: 腹膜透析相关性腹膜炎 控制营养状况评分 可溶性细胞间黏附分子-1 白蛋白 透析时间 超敏C-反应蛋白
Abstract:Objective To analyze the prognostic value of controlling nutritional status（CONUT）score combined with soluble intercellular adhesion molecule-1（sICAM-1）in predicting peritoneal dialysis-associated peritonitis（PDAP）.Methods A total of 176 patients with PDAP who received peritoneal dialysis treatment in the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to December 2023 were selected. After admission，the clinical data，CONUT scores and sICAM-1 levels of the dialysis effluent of all patients were collected. The patients were followed up for 3 months to evaluate their prognosis and were divided into poor prognosis group（n=60）and good prognosis group（n=116）. The clinical data，CONUT scores and sICAM-1 levels of patients were compared between the two groups，and the related factors affecting the prognosis of PDAP patients were analyzed by multivariate logistic regression. Pearson correlation was used to analyze the relationship between CONUT scores and sICAM- 1 levels.Receiver operateing characteristic（ROC） curve was used to analyze the prognostic value of CONUT score combined with sICAM-1 level in PDAP. Results Among the 176 PDAP patients，60 cases（34.09%）had poor prognosis. Multivariate logistic regression analysis showed that longer dialysis time，higher serum high-sensitivity C-
reactive protein（hs-CRP）level，lower serum albumin level，higher CONUT score and higher sICAM-1 level were independent risk factors for poor prognosis in PDAP patients（P＜0.05）. Pearson correlation analysis showed that CONUT score was positively correlated with sICAM-1（r=0.657，P＜0.05）. The ROC curve results showed that the area under the curve（AUC）was higher when the CONUT score was 12 and the sICAM-1 was 8.62 ng/mL，with AUC values of 0.819 and 0.778，respectively. The combined AUC of these two was 0.847. Conclusion CONUT score combined with sICAM-1 can effectively predict the prognosis of patients with PDAP，and has high clinical application value. Long dialysis time，high serum hs-CRP level，low albumin level，high CONUT score，and high sICAM-1 level in dialysis effluent may lead to poor prognosis.
keywords: Peritoneal dialysis-associated peritonitis Controlling nutritional status Soluble intercellular adhesion molecule-1 Albumin Dialysis time High-sensitivity C-reactive protein
文章编号： 中图分类号：R459.5 文献标志码：A
基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题（Z20200674）；广西中医药大学自然科学研究项目（2016MS016）；广西中医药适宜技术开发与推广项目（GZSY21-25）
附件
| Author Name | Affiliation |
| LIU E，LIAO Chaoyan，LU Haixia，QIN Zuolian | Department of Nephrology,First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi530023,China |
引用文本：
刘娥，廖朝艳，卢海霞，覃祚莲.控制营养状况评分联合透出液可溶性细胞间黏附分子-1预测腹膜透析相关性腹膜炎预后的价值[J].中国临床研究,2025,38(8):1227-1231.
刘娥，廖朝艳，卢海霞，覃祚莲.控制营养状况评分联合透出液可溶性细胞间黏附分子-1预测腹膜透析相关性腹膜炎预后的价值[J].中国临床研究,2025,38(8):1227-1231.