中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2009年
6期
411-414
,共4页
申伟%毛海萍%黄锋先%陈崴%杨琼琼%张小丹%胡丽琼%林建雄%董秀清%何慧娟%余学清
申偉%毛海萍%黃鋒先%陳崴%楊瓊瓊%張小丹%鬍麗瓊%林建雄%董秀清%何慧娟%餘學清
신위%모해평%황봉선%진외%양경경%장소단%호려경%림건웅%동수청%하혜연%여학청
腹膜透析%透析液%蛋白质%丢失%营养不良-炎性反应-动脉硬化综合征
腹膜透析%透析液%蛋白質%丟失%營養不良-炎性反應-動脈硬化綜閤徵
복막투석%투석액%단백질%주실%영양불량-염성반응-동맥경화종합정
Peritoneal dialysis%Dialysate%Protein%Loss%Malnutrition-inflammation-atherosclerosis syndrome
目的 探讨透出液蛋白丢失对连续性非卧床腹膜透析(CAPD)患者营养不良-炎性反应-动脉硬化(MIA)综合征的影响.方法 对130例无明显水肿和活动性感染的CAPD患者进行横断面的研究.用标准腹膜平衡试验(PET)评估CAPD患者腹膜转运功能.颈动脉彩色超声检测颈动脉内膜中层厚度(IMT).检测患者血清白蛋白、夜间留腹透出液蛋白和超敏C反应蛋白(hs-CRP)的水平.残余肾功能(rGFR)为24 h尿尿素氮和尿肌酐清除的平均值.结果 Pearson和Spearman相关分析显示,CAPD透出液蛋白的丢失与年龄、体质量指数(BMI)、夜间腹透液留腹的时间、血糖、4 h透出液肌酐与血肌酐比值(4 h D/Pcr)及hs-CRP水平呈正相关(分别为r=0.204,P<0.05;r=0.314,P<0.01;r=0.265,P<0.01;r=0.212,P<0.05;r=0.401,P<0.01和r=0.216,P<0.05);与舒张压、血清白蛋白、透析液糖浓度及腹膜Kt/V呈负相关(分别为r=-0.209,P<0.05;r=-0.123,P<0.05;r=-0.271,P<0.01;r=-0.212,P<0.01).总体上,透出液蛋白丢失量与IMT无相关,但患者rGFR小于1 ml·min-1·(1.73 m2)-1时,透出液蛋白丢失量与IMT呈正相关(r=0.650,P<0.01).结论 CAPD患者透出液蛋白的丢失与患者腹膜转运类型、营养不良和炎性反应状态密切相关.患者rGFR小于1 ml·min-1·(1.73 m2)->时,透出液蛋白的丢失是颈动脉动脉硬化的危险因素.
目的 探討透齣液蛋白丟失對連續性非臥床腹膜透析(CAPD)患者營養不良-炎性反應-動脈硬化(MIA)綜閤徵的影響.方法 對130例無明顯水腫和活動性感染的CAPD患者進行橫斷麵的研究.用標準腹膜平衡試驗(PET)評估CAPD患者腹膜轉運功能.頸動脈綵色超聲檢測頸動脈內膜中層厚度(IMT).檢測患者血清白蛋白、夜間留腹透齣液蛋白和超敏C反應蛋白(hs-CRP)的水平.殘餘腎功能(rGFR)為24 h尿尿素氮和尿肌酐清除的平均值.結果 Pearson和Spearman相關分析顯示,CAPD透齣液蛋白的丟失與年齡、體質量指數(BMI)、夜間腹透液留腹的時間、血糖、4 h透齣液肌酐與血肌酐比值(4 h D/Pcr)及hs-CRP水平呈正相關(分彆為r=0.204,P<0.05;r=0.314,P<0.01;r=0.265,P<0.01;r=0.212,P<0.05;r=0.401,P<0.01和r=0.216,P<0.05);與舒張壓、血清白蛋白、透析液糖濃度及腹膜Kt/V呈負相關(分彆為r=-0.209,P<0.05;r=-0.123,P<0.05;r=-0.271,P<0.01;r=-0.212,P<0.01).總體上,透齣液蛋白丟失量與IMT無相關,但患者rGFR小于1 ml·min-1·(1.73 m2)-1時,透齣液蛋白丟失量與IMT呈正相關(r=0.650,P<0.01).結論 CAPD患者透齣液蛋白的丟失與患者腹膜轉運類型、營養不良和炎性反應狀態密切相關.患者rGFR小于1 ml·min-1·(1.73 m2)->時,透齣液蛋白的丟失是頸動脈動脈硬化的危險因素.
목적 탐토투출액단백주실대련속성비와상복막투석(CAPD)환자영양불량-염성반응-동맥경화(MIA)종합정적영향.방법 대130례무명현수종화활동성감염적CAPD환자진행횡단면적연구.용표준복막평형시험(PET)평고CAPD환자복막전운공능.경동맥채색초성검측경동맥내막중층후도(IMT).검측환자혈청백단백、야간류복투출액단백화초민C반응단백(hs-CRP)적수평.잔여신공능(rGFR)위24 h뇨뇨소담화뇨기항청제적평균치.결과 Pearson화Spearman상관분석현시,CAPD투출액단백적주실여년령、체질량지수(BMI)、야간복투액류복적시간、혈당、4 h투출액기항여혈기항비치(4 h D/Pcr)급hs-CRP수평정정상관(분별위r=0.204,P<0.05;r=0.314,P<0.01;r=0.265,P<0.01;r=0.212,P<0.05;r=0.401,P<0.01화r=0.216,P<0.05);여서장압、혈청백단백、투석액당농도급복막Kt/V정부상관(분별위r=-0.209,P<0.05;r=-0.123,P<0.05;r=-0.271,P<0.01;r=-0.212,P<0.01).총체상,투출액단백주실량여IMT무상관,단환자rGFR소우1 ml·min-1·(1.73 m2)-1시,투출액단백주실량여IMT정정상관(r=0.650,P<0.01).결론 CAPD환자투출액단백적주실여환자복막전운류형、영양불량화염성반응상태밀절상관.환자rGFR소우1 ml·min-1·(1.73 m2)->시,투출액단백적주실시경동맥동맥경화적위험인소.
Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.
