■尚未使用标志物来诊断历史腹膜透析(PD)相关性腹膜炎。亲环蛋白A(CypA)与葡萄糖毒性和炎症相关。我们假设透析液CypA可以是历史腹膜炎(至少3个月无腹膜炎)的标志物。
■使用酶联免疫吸附测定试剂盒来测量透析液CypA的浓度。收集临床和实验室数据以与历史腹膜炎相关。采用Mann-WhitneyU检验和卡方检验进行分析。接收器工作特性(ROC)分析用于评估预测能力。
■在总共31名接受PD至少2年的患者中,18人无PD相关性腹膜炎病史,而13人至少经历过一次PD相关性腹膜炎。总的来说,该人群中的患者健康状况良好(白细胞计数正常,没有贫血,正常的电解质和血清白蛋白水平)。有和没有腹膜炎病史的患者之间没有显着差异,除血液白细胞计数外(5650.6±1848.4vs.7154.6±2056.8,p=0.032)和透析液CypA值(24.27±22.715vs.54.41±45.63,p=0.020)。在单变量分析中,只有透析液CypA水平与历史腹膜炎有统计学显著关联(HR=1.030,95%CI=1.010-1.062,p=0.046).透析液CypA(>34.83ng/mL)的AUC为0.748,灵敏度为0.615,特异性为0.833。
■PD腹膜炎对腹膜透析的长期使用构成了重大威胁。根据我们的研究,即使没有并发感染,透析液CypA可以作为历史腹膜炎的预测标志物,表现出较高的预测能力,以及相当的敏感性和良好的特异性。
UNASSIGNED: No markers have been used to diagnose historical peritoneal dialysis (PD)-related peritonitis. Cyclophilin A (CypA) is associated with glucose toxicity and inflammation. We hypothesize that dialysate CypA can be a marker for historical peritonitis (at least 3 months free from peritonitis).
UNASSIGNED: An enzyme-linked immunosorbent assay kit was used to measure the concentration of dialysate CypA. Clinical and laboratory data were collected to correlate with historical peritonitis. Mann-Whitney U test and Chi-square test were used for analysis. Receiver operating characteristic (ROC) analysis was used to evaluate predictive power.
UNASSIGNED: Out of a total of 31 patients who had undergone PD for at least 2 years, 18 had no history of PD-related peritonitis, while 13 had experienced PD-related peritonitis at least once. Overall, the patients in this population were in good health (normal white blood cell count, no anemia, normal electrolyte and serum albumin levels). There were no significant differences between patients with and without a history of peritonitis, except for blood white blood cell count (5650.6 ± 1848.4 vs. 7154.6 ± 2056.8, p = 0.032) and dialysate CypA value (24.27 ± 22.715 vs. 54.41 ± 45.63, p = 0.020). In the univariate analysis, only the dialysate CypA level showed a statistically significant association with historical peritonitis (HR = 1.030, 95 % CI = 1.010-1.062, p = 0.046). The AUC for dialysate CypA (>34.83 ng/mL) was 0.748, with a sensitivity of 0.615 and specificity of 0.833.
UNASSIGNED: PD peritonitis poses a significant threat to the long-term use of peritoneal dialysis. Based on our study, even in the absence of concurrent infection, dialysate CypA can serve as a predictive marker for historical peritonitis, demonstrating high predictive power along with fair sensitivity and good specificity.