持续性非卧床腹膜透析患者容量超负荷的影响因素分析

摘要

目的 探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者容量超负荷的影响因素.方法 对2008年9月～2009年3月在本院门诊随访的92例CAPD患者进行调查,按其水肿指数是否高于正常值0.40分为高水肿指数组(43例)和正常水肿指数组(49例),应用logistic回归分析筛查患者容量超负荷的影响因素.结果 单因素分析显示,高水肿指数组与正常水肿指数组患者年龄、是否患糖尿病、透析龄、尿量、总出液量、血浆肌酐浓度比值(D/Pcr)、血清白蛋白水平、自我效能方面组间比较,差异具有统计学意义(均P＜ 0.05).多因素分析显示,自我效能、血清白蛋白水平及年龄是容量超负荷影响因素,而且发现患者自我效能、血清白蛋白水平与水肿指数呈负相关,年龄与水肿指数呈正相关(均P＜ 0.05,).结论 自我效能、血清白蛋白水平及年龄是CAPD患者容量超负荷的影响因素,而且患者自我效能及血清白蛋白水平越低,年龄越大,其水肿指数越高,应针对性地进行控制.%Objective To investigate the risk factors of fluid overload in continuous ambulatory peritoneal dialysis (CAPD). Methods By cross-sectional study, 92 CAPD patients who followed-up in our hospital from September 2008 to March 2009 were included. According to their mean edema index (ECW/TBW = 0.40 ± 0.14), they were divided into two groups, fluid overload group (n = 43) and normal fluid group (n = 49). Multivariate statistical analysis with logistic regression was used to analyze the above variables to determine risk factors of fluid overload. Results By univariate analysis, CAPD patients' age, diabetes, the duration on PD, urine volume, volume ejection, D/Pcr, serum albumin, total fluid removal, and self-efficacy were significantly related with fluid overload (all P < 0.05). The risk factors of fluid overload included self-efficacy, the level of serum albumin and age. Conclusions Self-efficacy, the level of serum albumin and age are risk factors of fluid overload in CAPD patients. The lower the self-efficacy and the serum albumin level and the older the age, the higher edema index.