中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
7期
963-965
,共3页
终末期肾衰竭%腹膜透析%转归
終末期腎衰竭%腹膜透析%轉歸
종말기신쇠갈%복막투석%전귀
End stage renal disease%Peritoneal dialysis%Outcome
目的 探讨长期腹膜透析患者的临床转归及临床特点.方法 对海军总医院腹膜透析时间超过1年的67例腹膜透析患者临床资料进行回顾性分析.根据其临床转归分为维持腹膜透析组(37例)、转向血液透析组(4例)、转向移植组(2例)及死亡组(24例).结果 死亡组血清白蛋白水平及总尿素清除指数(Kt/V)明显低于维持腹膜透析组、转向血液透析组、转向移植组[(21±4)g/L比(29±6)、(30±4)、(36 ±7) g/L,(1.52±0.15)比(1.81±0.16)、(1.86±0.35)、(1.95±0.17),均P＜0.05].维持腹膜透析组水清除指标明显高于转向血液透析组、转向移植组及死亡组[日超滤量(UF)+尿量(UV):(1.93±0.33)L比(1.50±0.08)、(1.65 ±0.35)、(1.33±0.47)L,(UF+ UV)/体表面积:(1.14±0.12)比(1.04±0.03)、(1.07±0.09)、(0.87±0.37),均P＜0.05].维持腹膜透析组及转向移植组残肾功能明显高于转向血液透析组、死亡组[残肾Kt/V:(0.43 ±0.21)、(0.39±0.06)比(0.10±0.04)、(0.18±0.09),残肾内生肌酐清除率(Ccr):(13.1±8.8)、(17.8±2.7)L·周-1·(1.73 m2)-1比(2.4±1.1)、(5.0±2.1)L·周-1· (1.73 m2)-1,均P＜0.05].死亡组死亡前3个月总Kt/V及总Ccr均明显低于死亡前1年[分别为(1.52±0.15)比(1.82±0.17),(46 ±7)L·周-1·(1.73m2)-1比(58±6)L·周-1·(1.73m2)-1,P ＜0.05或P＜0.01].死亡组24例中有10例死于心脑血管疾病.结论 心脑血管疾病是死亡的最主要病因.透析不充分、营养不良以及血压控制不佳都是死亡的重要原因.残肾功能可影响预后.
目的 探討長期腹膜透析患者的臨床轉歸及臨床特點.方法 對海軍總醫院腹膜透析時間超過1年的67例腹膜透析患者臨床資料進行迴顧性分析.根據其臨床轉歸分為維持腹膜透析組(37例)、轉嚮血液透析組(4例)、轉嚮移植組(2例)及死亡組(24例).結果 死亡組血清白蛋白水平及總尿素清除指數(Kt/V)明顯低于維持腹膜透析組、轉嚮血液透析組、轉嚮移植組[(21±4)g/L比(29±6)、(30±4)、(36 ±7) g/L,(1.52±0.15)比(1.81±0.16)、(1.86±0.35)、(1.95±0.17),均P＜0.05].維持腹膜透析組水清除指標明顯高于轉嚮血液透析組、轉嚮移植組及死亡組[日超濾量(UF)+尿量(UV):(1.93±0.33)L比(1.50±0.08)、(1.65 ±0.35)、(1.33±0.47)L,(UF+ UV)/體錶麵積:(1.14±0.12)比(1.04±0.03)、(1.07±0.09)、(0.87±0.37),均P＜0.05].維持腹膜透析組及轉嚮移植組殘腎功能明顯高于轉嚮血液透析組、死亡組[殘腎Kt/V:(0.43 ±0.21)、(0.39±0.06)比(0.10±0.04)、(0.18±0.09),殘腎內生肌酐清除率(Ccr):(13.1±8.8)、(17.8±2.7)L·週-1·(1.73 m2)-1比(2.4±1.1)、(5.0±2.1)L·週-1· (1.73 m2)-1,均P＜0.05].死亡組死亡前3箇月總Kt/V及總Ccr均明顯低于死亡前1年[分彆為(1.52±0.15)比(1.82±0.17),(46 ±7)L·週-1·(1.73m2)-1比(58±6)L·週-1·(1.73m2)-1,P ＜0.05或P＜0.01].死亡組24例中有10例死于心腦血管疾病.結論 心腦血管疾病是死亡的最主要病因.透析不充分、營養不良以及血壓控製不佳都是死亡的重要原因.殘腎功能可影響預後.
목적 탐토장기복막투석환자적림상전귀급림상특점.방법 대해군총의원복막투석시간초과1년적67례복막투석환자림상자료진행회고성분석.근거기림상전귀분위유지복막투석조(37례)、전향혈액투석조(4례)、전향이식조(2례)급사망조(24례).결과 사망조혈청백단백수평급총뇨소청제지수(Kt/V)명현저우유지복막투석조、전향혈액투석조、전향이식조[(21±4)g/L비(29±6)、(30±4)、(36 ±7) g/L,(1.52±0.15)비(1.81±0.16)、(1.86±0.35)、(1.95±0.17),균P＜0.05].유지복막투석조수청제지표명현고우전향혈액투석조、전향이식조급사망조[일초려량(UF)+뇨량(UV):(1.93±0.33)L비(1.50±0.08)、(1.65 ±0.35)、(1.33±0.47)L,(UF+ UV)/체표면적:(1.14±0.12)비(1.04±0.03)、(1.07±0.09)、(0.87±0.37),균P＜0.05].유지복막투석조급전향이식조잔신공능명현고우전향혈액투석조、사망조[잔신Kt/V:(0.43 ±0.21)、(0.39±0.06)비(0.10±0.04)、(0.18±0.09),잔신내생기항청제솔(Ccr):(13.1±8.8)、(17.8±2.7)L·주-1·(1.73 m2)-1비(2.4±1.1)、(5.0±2.1)L·주-1· (1.73 m2)-1,균P＜0.05].사망조사망전3개월총Kt/V급총Ccr균명현저우사망전1년[분별위(1.52±0.15)비(1.82±0.17),(46 ±7)L·주-1·(1.73m2)-1비(58±6)L·주-1·(1.73m2)-1,P ＜0.05혹P＜0.01].사망조24례중유10례사우심뇌혈관질병.결론 심뇌혈관질병시사망적최주요병인.투석불충분、영양불량이급혈압공제불가도시사망적중요원인.잔신공능가영향예후.
Objective To analyze the clinical data of long-term peritoneal dialysis (PD) patients; to discuss the clinical outcomes and clinical features.Methods The data of 67 PD patients survived more than 1 year were reviewed.According to the different clinical outcomes,the patients were divided into four groups:continuous PD group,hemodialysis (HD) group,transplant group and death group.Results The recent serum albumin and total Kt/V in death group were significantly lowered than those in other three groups[(21 ±4) g/L vs (29 ±6),(30 ±4),(36 ±7)g/L,(1.52 ±0.15)vs (1.81 ±0.16),(1.86 ±0.35),(1.95 ±0.17),all P＜0.05].The fluid removal in continuous PD group was significantly higher than that in the other three groups[urinary filtration(UF) + urinary volume(UV):(1.93 ±0.33)L vs (1.50 ±0.08),(1.65 ±0.35),(1.33 ±0.47)L,(UF + UV)/body surface area(BSA):(1.14 ±0.12) vs (1.04 ±0.03),(1.07 ±0.09),(0.87 ±0.37),all P＜0.05].The residual renal Kt/V or residual renal Ccr in continuous PD group and transplant group were significantly higher than those in HD and death groups [Kt/V:(0.43 ± 0.21),(0.39 ± 0.06) vs (0.10 ± 0.04),(0.18 ± 0.09),endogenous creatinine clearance rate(Ccr):(13.1 ± 8.8),(17.8 ± 2.7) L · week-1 · (1.73 m2)-1 vs (2.4 ± 1.1),(5.0 ± 2.1) L · week-1 · (1.73 m2)-1,all P ＜ 0.05].Compared to one year prior to death,the total Kt/V and total Ccr of the three months prior to death in death group was significantly lower[(1.52 ± 0.15) vs (1.82 ±0.17),(46 ±7)L· week-1 · (1.73 m2)-1 vs (58 ±6)L· week-1 · (1.73 m2)-1,P＜0.05 orP＜0.01].Ten out of twenty-four in death group died of cardiovascular diseases and cerebrovascular diseases.Conclusions Cardiovascular and cerebrovascular diseases are the leading causes of death.Dialysis inadequacy,undernutrition and poor blood pressure control are important causes of death.Residual renal function can affect the prognosis.
