目的: 分析腹膜透析相关性腹膜炎的病原菌分布及耐药性，评价替考拉宁腹腔注射治疗腹膜透析相
关性腹膜炎的疗效及安全性，以期为腹膜透析相关性腹膜炎的治疗提供证据。方法: ( 1) 收集我院近5a 58 例次
持续不卧床腹膜透析发生过腹膜炎病人的临床资料，分析其病原菌分布及耐药性。( 2) 58 例次病人中实验组给
予替考拉宁腹腔给药治疗21 例次，对照组应用其他治疗方案治疗37 例次，观察两组疗效、不良反应，比较替考
拉宁治疗前后腹水常规、超敏C 反应蛋白、血常规、肝肾功的变化。结果: ( 1) 58 例次受试者中细菌培养结果阳
性33 例次，阳性率为56．90%，其中G+占69．70%; 药敏试验提示，G+ 对替考拉宁、万古霉素耐药率为0，G－ 对亚胺
培南耐药率为0。( 2) 两组临床总有效率分别为85．71%、73．68%，不良反应发生率分别为4．76%、5．41%，差异无
统计学意义。( 3) 病人腹水常规多形核细胞百分比、超敏C 反应蛋白经替考拉宁腹腔给药治疗后较治疗前下
降，差异有统计学意义( P＜0．05) ，血WBC、ＲBC、PLT、ALT、AST、Cr 治疗前后无明显变化，差异无统计学意义。结
论: 腹腔注射替考拉宁在腹膜透析相关性腹膜炎的治疗中，临床疗效好，药物不良反应少，值得临床进一步推广。
关键词: 替考拉宁; 腹膜炎; 腹膜透析; 病原菌

Objective: To analyze the changes of pathogens and antimicrobial susceptibilities in
peritoneal dialysis－related peritonitis．To evaluate the efficacy and safety of teicoplanin intraperitoneal
injection treatment in peritoneal dialysis－related peritonitis，which in order to provide evidence for the
treatment of PD related peritonitis．Methods: We collectted the peritoneal dialysis－related peritonitis
patients treated in the recent 5 years( 58cases) in our department，and retrospectively analyzed their
general condition，pathogens，antimicrobial susceptibilities，and efficacy． The experimental group were
given teicoplanin intraperitoneal therapy， the control group receiving other treatment， the efficacy and
adverse reactions rate were compared．To contrast the changes of scites routine examination，CRP，blood
routine examination， liver and kidney function before and after teicoplanintreatment．Results: ( 1) In the
58 samples for microbial culture，33samples were positive for pathogens， the positive rate was 56．90%，
in which Gram－positive bacteria rate was 69．70%． In the isolated Grampositive bacteria， the rates to
vancomycin and teicoplanin were zero．In the isolated Gram－negative bacteria， the antibiotic resistance
rates to imipenem were zero． ( 2) The clinical total effective rate of the two groups were 85．71%and
73．68%，adverse reaction rates were 4．76%and 5．41%，and the two groups had no statistical significance．(
3) After intraperitoneal teicoplanin treatment， the percentage of polymorphonuclear cells in ascites
routine，hCRP decreased significantly than before treatment，the difference was statistically
significant( P＜0．05) ．The changes of WBC、RBC、PLT、ALT、AST and Cr was no statistical significance
before and after the treatment．Conclusion: It is high effective and safe to use intraperitoneal injection
teicoplanin in the patients of peritoneal dialysis－related peritonitis，which is worthy of further promotion．

R572

 收稿日期: 2016－12－18; 修回日期: 2017－02－21
基金项目: 内蒙古自治区人才开发基金( 2015)
作者简介: 许珊珊( 1987－) ，女，蒙古族，内蒙古医科大学附属医院肾内科住院医师，医学硕士。
通讯作者: 赵建荣，教授，主任医师，医学博士，E－mail: jrzhao33@ souhu．com 内蒙古医科大学附属医院肾内科， 010050