目的 分析柳氮磺吡啶初始治疗腹膜透析相关腹膜炎的临床应用价值。方法 选取万宁市人民医院2020年1月—2022年1月收治的120例腹膜透析相关腹膜炎患者，按照随机分组法分为对照组（60例）和治疗组（60例）。两组均给予连续性非卧床腹膜透析。对照组患者给予常规初始治疗，包括腹膜透析、抗感染干预和基础干预。治疗组在对照组基础上口服柳氮磺吡啶肠溶片，初始剂量1 g/次，若无不适则增至2 g/次，3次/d。两组均治疗3 d，3 d后根据患者病情调整治疗方案。观察两组患者临床疗效，比较治疗前后两组患者临床症状消失时间，透析液高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和血液血小板/淋巴细胞（PLR）、中性粒细胞/淋巴细胞（NLR）水平，及肠道屏障功能。结果 治疗后，治疗组总有效率（88.33%）明显高于对照组（70.00%，P＜0.05）。治疗组腹痛、腹胀、恶心消失时间较对照组显著缩短（P＜0.05）。治疗后，两组透析液hs-CRP、IL-6、NGAL及血液PLR、NLR水平低于治疗前（P＜0.05），且治疗组较明显低于对照组（P＜0.05）。治疗后，两组乳果糖排泄率较治疗前降低、甘露醇排泄率较治疗前提高（P＜0.05），且治疗组改善幅度更显著（P＜0.05）。结论 柳氮磺吡啶初始治疗腹膜透析相关腹膜炎具有确切效果，可有效缓解炎症反应，且对肠道屏障功能恢复有一定作用，安全可靠。

Objective To analyze the clinical value of sulfasalazine for the initial treatment of peritoneal dialysis-associated peritonitis. Methods Patients (120 cases) with peritoneal dialysis-associated peritonitis in People's Hospital of Wanning from January 2020 to January 2022 were divided into control (60 cases) and treatment (60 cases) group by random grouping method. Patients in two groups were given continuous ambulatory peritoneal dialysis. Patients in the control group were given routine initial treatment, including peritoneal dialysis, anti-infective intervention and basic intervention. Patients in the treatment group were po administered with Sulfasalazine Enteric-Coated Tablets on the basis of the control group, the initial dose was 1 g/time, and if there was no discomfort, the dose was increased to 2 g/time, 3 times daily. Patients in two groups were treated for 3 d, and the treatment plan was adjusted according to the patient's condition after 3 d. After treatment, the clinical evaluation was evaluated, and the disappearance time of clinical symptoms, dialysate hs-CRP, IL-6, NGAL and blood PLR, NLR levels, and intestinal barrier function in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (88.33%) was significantly higher than that of the control group (70.005%, P < 0.05). The disappearance time of abdominal pain, abdominal distension and nausea in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the levels of hs-CRP, IL-6, and NGAL in dialysate and blood PLR and NLR in two groups were lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the lactulose excretion rate in two groups was significantly decreased and the mannitol excretion rate was significantly increased (P < 0.05), and the improvement in the treatment group was significantly higher than that in the control group (P < 0.05). Conclusion Sulfasalazine has a definite effect in the initial treatment of peritoneal dialysis-related peritonitis, can effectively alleviate the inflammatory reaction, and has a certain effect on the recovery of intestinal barrier function, which is safe and reliable.

R977

海南省卫生健康行业科研项目（19A200142）