CAJ | 학술논문

目的：探讨持续非卧床腹膜透析( CAPD )患者的肺功能变化及与炎性标志物和透析相关指标的相关性。方法选择CAPD超过2个月的患者101例，根据患者炎性标志物与透析相关指标水平分组，比较各组间肺功能指标的变化。结果通过测量肺活量( VC)、用力肺活量( FVC)、一秒钟用力呼气容积(FEV1)、最大呼气流速(PEF)、75%最大呼气流量( MEF75)、50%最大呼气流量( MEF50)、25%最大呼气流量( MEF25)、最大呼气中段流量( MMEF )、最大通气量(MVV)、肺一氧化碳弥散量(DLCO)来检测肺功能，数据以VC%、FVC%、FEV1%、PEF%、MEF75%、MEF50%、MEF25%、MMEF%、MVV%和DLCO%呈现， CAPD患者均明显低于正常者(P <0.05)。分组比较显示 C-反应蛋白(CRP)≥10 mg/L患者的 VC%、FVC%、PEF%、DLCO%水平明显低于CRP<10 mg/L患者(P<0.05)；血清白蛋白(Alb)<35 g/L患者DLCO%水平明显低于Alb≥35 g/L患者(P<0．05)；总尿素氮清除指数( Kt/v )<1．7患者 MEF50%、MEF25%、MMEF%、MVV%明显低于总Kt/v≥1.7患者(P<0．05)；残余肾小球滤过率( rGFR)<1 ml/min 的患者 MEF25%、DL-CO%明显低于rGFR≥1 ml/min患者(P<0.05)；标准化蛋白氮呈现率(nPNA)<1 g/(kg·d)的患者FVC%、PEF%、MEF75%、MMEF%、MVV%明显低于nPNA≥1 g/( kg·d)患者(P<0.05)。结论 CAPD患者血清 CRP水平升高、Alb水平降低及透析不充分、残余肾功能( RRF)下降可能与肺功能损害有关。
목적：탐토지속비와상복막투석( CAPD )환자적폐공능변화급여염성표지물화투석상관지표적상관성。방법선택CAPD초과2개월적환자101례，근거환자염성표지물여투석상관지표수평분조，비교각조간폐공능지표적변화。결과통과측량폐활량( VC)、용력폐활량( FVC)、일초종용력호기용적(FEV1)、최대호기류속(PEF)、75%최대호기류량( MEF75)、50%최대호기류량( MEF50)、25%최대호기류량( MEF25)、최대호기중단류량( MMEF )、최대통기량(MVV)、폐일양화탄미산량(DLCO)래검측폐공능，수거이VC%、FVC%、FEV1%、PEF%、MEF75%、MEF50%、MEF25%、MMEF%、MVV%화DLCO%정현， CAPD환자균명현저우정상자(P <0.05)。분조비교현시 C-반응단백(CRP)≥10 mg/L환자적 VC%、FVC%、PEF%、DLCO%수평명현저우CRP<10 mg/L환자(P<0.05)；혈청백단백(Alb)<35 g/L환자DLCO%수평명현저우Alb≥35 g/L환자(P<0．05)；총뇨소담청제지수( Kt/v )<1．7환자 MEF50%、MEF25%、MMEF%、MVV%명현저우총Kt/v≥1.7환자(P<0．05)；잔여신소구려과솔( rGFR)<1 ml/min 적환자 MEF25%、DL-CO%명현저우rGFR≥1 ml/min환자(P<0.05)；표준화단백담정현솔(nPNA)<1 g/(kg·d)적환자FVC%、PEF%、MEF75%、MMEF%、MVV%명현저우nPNA≥1 g/( kg·d)환자(P<0.05)。결론 CAPD환자혈청 CRP수평승고、Alb수평강저급투석불충분、잔여신공능( RRF)하강가능여폐공능손해유관。
Objective To analyze the relationship between pulmonary function and the inflammatory biomarker and the dialysis index in continuous ambulatory peritoneal dialysis ( CAPD ) patients. Methods 101 patients with CAPD more than two months in the first affiliated hospital of Anhui Medical University were enrolled. The patients were allocated in two groups according to the result of inflammatory biomarkers and the dialysis index. The pulmo-nary function index was compared between two groups. Results Pulmonary function tests showed vital capacity (VC), maximal voluntary ventilation (MVV), forced vital capacity (FVC), the forced expiratory volume of the first second (FEV1), peak expiratory flow (PEF), 75% of maximal expiratory flow (MEF75), 50%of maximal expiratory flow (MEF50), 25%of maximal expiratory flow (MEF25), maximal mid-expiratory flow rate(MMEF), diffusing capacity of the lung for carbon monoxide ( DLCO) of CAPD group were lower than the control group ( P<0. 05). VC%,FVC%,PEF%,DLCO% in the patients with CRP≥ 10 mg/L were lower than the patients with CRP<10 mg/L. DLCO% in the patients with Alb<35 g/L were lower than that the patients with Alb≥35 g/L. MEF50%,MEF25%,MMEF%,MVV% were higher in the patients with Kt/v≥1. 7 than the patients with Kt/v<1. 7, also in the patients with rGFR≥1 ml/min. MEF25%,DLCO% were higher in the patients with rGFR< 1 ml/min. FVC%,PEF%,MEF75%,MMEF%,MVV% in the patients with nPNA< 1 g/( kg·d) were lower than the patients with nPNA≥1 g/( kg·d) . Conclusion Pulmonary function injury has relationship with higher value of CRP, hypoalbuminemia, dialysis inadequacy and decrease of residual renal function.