腹膜转运特性对持续不卧床腹膜透析患者营养状况的影响

摘要

Objective To explore the influence of peritoneal transport characteristics on the nutritional status of patients with continuous ambulatory peritoneal dialysis ( CAPD ). Methods Fifty - five CAPD patients were involved in this cross - sectional study. According to the results of peritoneal equilibration test ( PET ), the patients were divided into high transport group with 24 cases and low transport group with 31 cases. Nutritional status was evaluated with the subjective global assessment ( SGA ) score. Albumin ( Alb ), total protein ( TP ), hemoglobin ( Hb ) , dialysis time , blood urea nitrogen ( BUN ) , serum creatinine ( Scr ) , Kt/V, TCcr, daily dialysis dosage, ultrafiltration volume, urine output, blood glucose, residual renal function ( GFR ), weight,high -sensitivity C - reactive protein( Hs - CRP ) were compared and analyzed between two groups. Results There was no difference between two groups in dialysis time, daily dialysis dosage, ultrafiltration volume, BUN, Scr, TCcr, Hb, weight and blood pressure( P >0. 05 ). Compared to low transport group, the four hours of dialysis fluid/serum creatinine( D/P4cr )was significantly increased in high transport ones while Kt/V (2. 11 ±0.57vs. 1.71 ±0.49), TP(69.51 ±6. 06vs.65. 93 ±7.57 )g · L-1 , Alb( 35.24 ±3. 75vs. 31. 45 ± 4. 42 )g · L-1 were significant reduced ( P <0. 05 ). Kt/V was positively correlated with serum albumin( r = 0. 383 ,P < 0. 01 ), D/P4cr were negatively correlated with serum total protein and albumin( r = -0. 286, -0. 341 ,P <0. 05 ). Conclusion The nutritional status of CAPD patients with different transport characteristics have significant difference. CAPD patients with high transport characteristics are complicated with worse nutritional status, compared to those patients with low transport characteristics.%目的 探讨持续不卧床腹膜透析(CAPD)患者腹膜转运特性对营养状况的影响.方法 对55例CAPD患者进行分析、研究,按照腹膜平衡试验(PET)的结果 分为高转运组(24例)和低转运组(31例).采用主观综合性营养评估(SGA)方法 评估患者营养状况及两组患者血清总蛋白(TP)、白蛋白(Alb)、血红蛋白(Hb)、透析龄、血尿素氮(BUN)、血肌酐(Scr)、Kt/V、TCcr、每日透析液剂量、超滤量、尿量、血糖、残余肾功能(GFR)、体重及超敏C反应蛋白(Hs-CRP)等进行比较.结果 两组患者的透析龄、透析剂量、超滤量、BUN、Scr、TCcr、Hb、GFR、体重、血压比较差异均无统计学意义;与低转运组比较高转运组D/P4肌酐(0.56±0.55 vs 0.77±0.42)显著升高,Kt/V(2.11±0.57 vs 1.71±0.49)、TP(69.51±6.06 vs 65.93±7.57)g·L-1、Alb(35.24±3.75 vs 31.45±4.42)g·L-1显著降低,差异均有统计学意义(P＜0.05).Kt/V与血清白蛋白呈正相关(r=0.383,P＜0.01),D/P4肌酐与血清总蛋白及白蛋白均呈负相关(r=-0.286,-0.341,P＜0 05).结论 CAPD不同腹膜转运特性患者的营养状况存在明显差异,腹膜透析高转运患者营养状况较低转运者差.