Level Of CRP,PCR And CA-125 In Peritoneal Fluid And Its Clincal Significance In Peritoneal Dialysis Related Peritonitis

Objective By testing the level of peritoneal fluid CRP ? PCT and CA-125 with peritoneal dialysis-related peritonitis patients and stable peritoneal dialysis patients,then comparing with their various clinical data.we discuss their clinical siginificance in the different level of peritoneal fluid CRP,PCT,CA-125 in peritoneal dialysis-related peritonitis patiens.Methods We collect 60 patients who are made a definite diagnosis with peritoneal dialysis related peritonitis during July 2013 to July 2016 in our hospital.According to different results for peritoneal fluid culture,we divided them to three groups,they are gram positive bacteria group(n = 24),gram negative bacteria group(n = 16)and culture negative group(n = 20),respectively.Also,we choose stable peritoneal dialysis patients(n=30)as control group.In addition,we assemble general clinical data of all patients and keep their the first bag of peritoneal fluid after they are admitted to our hospital(at least stay in abdominal cavity over 2 hours),and then we test the levels of CRP though Latex-enhanced immunoturbidimetric assay,the levels of PCT by fluorescent enzyme immunoassay and the levels of CA-125 by electrochemilu minescene immunoassay.At the same time,peritoneal fluid is delivered to clinical laboratory to bacterial cultivation.Results(1)Objects of age,hemoglobin,parathyroid hormone and ferritin have no differences between two groups(p>0.05);The levels of leukocyte,the percentage of neutrophil and C-reactive protein in blood with peritonitis patients were significantly higher than those of control group,the difference was statistically significant(p<0.05);The levels of serum creatinine,serum albumin,transferrin and transferrin saturation decreased significantly(p<0.05).(2)Compared with control group,the levels of peritoneal fluid CRP,PCT,CA-125 in peritonitis group increased obviously,the difference was statistically significant(p<0.05);Compared with control group,the levels of PCT,CA-125,WBC count and the percentage of neutrophil in peritoneal fluid were significantly higher in G+ group,G-group and culture negative group(p<0.05);but CRP has no significance among these three groups(p>0.05).(3)Comparison among G+group,G-group and culture negative group,peritoneal fluid CA-125 in G+ group were significantly higher than those in culture negative group;peritoneal fluid neutrophil in G-group were significantly higher than those in culture negative group;however,above indicators between G+ group and G-group have no significant differences(p>0.05).(4)Peritoneal fluid PCT and CA-125 were positively corrected with WBC count in peritoneal fluid(r=0.446,0.325 respectively,and p<0.05);whereas,peritoneal fluid CRP has no correlation with WBC count in peritoneal fluid(r=0.001,p>0.05).(5)To explore predictive value of 4 indicators for the occurrence of peritoneal dialysis related peritonitis and the results of peritoneal fluid culture,which are peritoneal fluid CRP,PCT,CA-125 and WBC,we implemented equation fitting by using Binary classification logistic regression analysis and get the results that peritoneal fluid CA-125 significantly associated with peritonitis(OR=1.108,p<0.05)and positive culture,as well(OR=0.964,p<0.05).Above indicators between G+ group and G-group have no significant differences yet(p>0.05).Conclusion increasing level of Peritoneal fluid CRP,PCT,CA-125 could be used to be as a reliable index of peritoneal dialysis related peritonitis,increasing level of peritoneal fluid CA-125 could distinguish positive culture and negative culture,and could predict peritonitis of positive culture reliably.