腹透患者透出液癌抗原125水平变化与患者预后的关系

发布时间：2018-05-24 17:39

本文选题：腹膜透析 + 癌抗原　；参考：《上海交通大学学报(医学版)》2016年03期

【摘要】：目的探讨腹膜透析(腹透)患者透出液中癌抗原125(CA125)水平变化对患者预后的影响。方法入选2005年1月—2009年12月间在上海交通大学医学院附属仁济医院腹透中心行持续性非卧床腹透且透析12个月以上的资料完整的患者。入选患者在开始腹透时测定透出液中CA125(dCA125)浓度,腹透12个月后复测dCA125;根据dCA125变化的中位数,将患者分为dCA125稳定组和dCA125升高组;所有患者随访至死亡、退出腹透、转其他中心、失访或至研究终止日期(2014年6月30日)。采用Kaplan-Meier法比较两组患者生存率、技术生存率以及无腹膜炎生存时间,采用Cox比例风险模型分析与患者预后相关的独立危险因素。结果共有111例患者入选本研究,平均年龄(53.5±14.7)岁,男性患者53例(47.7%),27例(24.3%)患者合并糖尿病。两组患者的基线人口学资料、临床指标等差异均无统计学意义。研究期间,dCA125稳定组(n=55)患者共发生73次腹膜炎,平均腹膜炎发生率为1次/50.0病人月;dCA125升高组(n=56)患者共发生44次腹膜炎,平均腹膜炎发生率为1次/75.3病人月。dCA125稳定组患者的无腹膜炎生存时间明显短于dCA125升高组患者(log-rank 6.133,P=0.013)。两组患者的长期生存率(log-rank 2.108,P=0.147)和技术生存率(log-rank 0.108,P=0.743)差异均无统计学意义。Cox比例风险模型分析显示:dCA125升高(HR 0.538,95%CI 0.296~0.979,P=0.03)是患者发生腹膜炎的独立保护因素。结论腹透患者dCA125升高是发生腹膜炎的保护因素,而dCA125的变化与患者长期生存率、技术生存率无关。检测dCA125水平的变化可能可预测腹透患者腹膜炎的发生。
[Abstract]:Objective to investigate the effect of cancer antigen 125 CA 125 in peritoneal dialysis (peritoneal dialysis) on prognosis. Methods from January 2005 to December 2009, patients who underwent continuous ambulatory peritoneal dialysis at Renji Hospital affiliated to Shanghai Jiaotong University Medical College and who had been undergoing dialysis for more than 12 months were enrolled. The patients were divided into stable dCA125 group and elevated dCA125 group according to the median of dCA125 changes. All the patients were followed up until death, exited peritoneal dialysis, and transferred to other centers. Lost visit or to the end of the study date (30 June 2014). The survival rate, technique survival rate and peritonitis survival time of the two groups were compared by Kaplan-Meier method. The independent risk factors associated with prognosis were analyzed by Cox proportional risk model. Results A total of 111 patients were enrolled in this study, with an average age of 53.5 卤14.7 years. There were 53 male patients with diabetes mellitus. There was no significant difference in baseline demographic data and clinical indexes between the two groups. During the study, 73 peritonitis occurred in patients with stable dCA125) and 44 peritonitis occurred in patients with elevated dCA125 per month (mean incidence of peritonitis was 1 / 50.0 patients per month). The mean peritonitis survival time of the stable group was significantly shorter than that of the patients with elevated dCA125. The mean incidence of peritonitis was 6.133.The survival time of the stable group was significantly shorter than that of the patients with elevated dCA125. The long-term survival rate (log-rank 2.108) and the technical survival rate (log-rank 0.108 P0.743) were not significantly different between the two groups. The Cox proportional risk model analysis showed that the increase of HR 0.53895 CI 0.296 / 0.979P0.03) was an independent protective factor for peritonitis. Conclusion the elevation of dCA125 is the protective factor of peritonitis in peritoneal dialysis patients, but the change of dCA125 is not related to long term survival rate and technical survival rate. Changes in dCA125 levels may predict peritonitis in patients with peritoneal dialysis.
【作者单位】：上海交通大学医学院附属仁济医院肾脏科上海市腹膜透析研究中心;
【分类号】：R692.5

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