中国临床保健杂志
中國臨床保健雜誌
중국림상보건잡지
CHINESE JOURNAL OF CLINICAL HEALTHCARE
2014年
6期
595-598
,共4页
万美燕%韩昆%崔永军%夏平
萬美燕%韓昆%崔永軍%夏平
만미연%한곤%최영군%하평
肾功能不全%腹膜透析,持续不卧床%通透性%心脏病
腎功能不全%腹膜透析,持續不臥床%通透性%心髒病
신공능불전%복막투석,지속불와상%통투성%심장병
Renal insufficiency%Peritoneal dialysis,continuous ambulatory%Permeability%Heart diseases
目的:探讨持续非卧床腹膜透析(CAPD)患者不同腹膜通透性对患者心脏结构的影响。方法选择透析12个月的 CAPD 患者52例,根据腹膜平衡实验(PET)结果将患者分为两组:高转运、高平均转运的患者为高通透性(H)组27例,低转运和低平均转运患者为低通透性(L)组25例。检测患者左心房内径(LAD)、左心室内径(LVD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)及左心室射血分数(LVEF),并进行比较。结果与 L 组相比,H 组患者血浆白蛋白[(33.46±3.08)g/L 比(35.72±2.62)g/L,P =0.006)]明显降低,腹透液白蛋白丢失量[(6.41±1.15)g/24h 比(5.51±1.18)g/24h,P =0.008]明显增多,室间隔厚度[(1 1.67±1.14)mm 比(10.96±0.97)mm,P =0.020]、左室后壁厚度[(10.16±0.93)mm 比(9.52±0.91) mm,P =0.016]明显增厚,左室射血分数[(59.37±3.31)%比(61.76±4.57)%,P =0.035]明显下降。单因素相关分析结果显示:腹透液白蛋白丢失量与血浆白蛋白及 LVEF 呈负相关关系(r =-0.503,P <0.01;r =-0.406,P =0.003);与 IVST、LVPWT 呈正相关关系(r =0.442,P =0.001;r =0.328,P =0.018)。结论高通透性 CAPD 患者较低通透性 CAPD 患者,左心室肥厚与左室射血功能的下降明显;腹透液白蛋白丢失量与CAPD 患者的心脏改变有相关性。
目的:探討持續非臥床腹膜透析(CAPD)患者不同腹膜通透性對患者心髒結構的影響。方法選擇透析12箇月的 CAPD 患者52例,根據腹膜平衡實驗(PET)結果將患者分為兩組:高轉運、高平均轉運的患者為高通透性(H)組27例,低轉運和低平均轉運患者為低通透性(L)組25例。檢測患者左心房內徑(LAD)、左心室內徑(LVD)、室間隔厚度(IVST)、左室後壁厚度(LVPWT)及左心室射血分數(LVEF),併進行比較。結果與 L 組相比,H 組患者血漿白蛋白[(33.46±3.08)g/L 比(35.72±2.62)g/L,P =0.006)]明顯降低,腹透液白蛋白丟失量[(6.41±1.15)g/24h 比(5.51±1.18)g/24h,P =0.008]明顯增多,室間隔厚度[(1 1.67±1.14)mm 比(10.96±0.97)mm,P =0.020]、左室後壁厚度[(10.16±0.93)mm 比(9.52±0.91) mm,P =0.016]明顯增厚,左室射血分數[(59.37±3.31)%比(61.76±4.57)%,P =0.035]明顯下降。單因素相關分析結果顯示:腹透液白蛋白丟失量與血漿白蛋白及 LVEF 呈負相關關繫(r =-0.503,P <0.01;r =-0.406,P =0.003);與 IVST、LVPWT 呈正相關關繫(r =0.442,P =0.001;r =0.328,P =0.018)。結論高通透性 CAPD 患者較低通透性 CAPD 患者,左心室肥厚與左室射血功能的下降明顯;腹透液白蛋白丟失量與CAPD 患者的心髒改變有相關性。
목적:탐토지속비와상복막투석(CAPD)환자불동복막통투성대환자심장결구적영향。방법선택투석12개월적 CAPD 환자52례,근거복막평형실험(PET)결과장환자분위량조:고전운、고평균전운적환자위고통투성(H)조27례,저전운화저평균전운환자위저통투성(L)조25례。검측환자좌심방내경(LAD)、좌심실내경(LVD)、실간격후도(IVST)、좌실후벽후도(LVPWT)급좌심실사혈분수(LVEF),병진행비교。결과여 L 조상비,H 조환자혈장백단백[(33.46±3.08)g/L 비(35.72±2.62)g/L,P =0.006)]명현강저,복투액백단백주실량[(6.41±1.15)g/24h 비(5.51±1.18)g/24h,P =0.008]명현증다,실간격후도[(1 1.67±1.14)mm 비(10.96±0.97)mm,P =0.020]、좌실후벽후도[(10.16±0.93)mm 비(9.52±0.91) mm,P =0.016]명현증후,좌실사혈분수[(59.37±3.31)%비(61.76±4.57)%,P =0.035]명현하강。단인소상관분석결과현시:복투액백단백주실량여혈장백단백급 LVEF 정부상관관계(r =-0.503,P <0.01;r =-0.406,P =0.003);여 IVST、LVPWT 정정상관관계(r =0.442,P =0.001;r =0.328,P =0.018)。결론고통투성 CAPD 환자교저통투성 CAPD 환자,좌심실비후여좌실사혈공능적하강명현;복투액백단백주실량여CAPD 환자적심장개변유상관성。
Objective To explore the influence of different peritoneal transport on cadiac structure of perito-neal dialysis(PD)patients.Method A total of 52 patients with PD followed up more than 1 2 months were enrolled in this study.Patients were divided into two groups through peritoneal equilibration test(PET):27 patients were high permeability(H)group included high-average and high transporters (H/A,D/P >0.65),and 25 patients were low permeability(L)group included low-average and low transporters(L/A,D/P≤0.65).Plasma albumin,creatinine, blood urea nitrogen and protein loss of dialysate were measured in all patients.Meanwhile LAD、LVD、IVST、LVPWT、LVEF were measured by ultrasonic Doppler before and after peritoneal dialysis.Results Compared with L group,the serum albumin[(33.46 ±3.08)g/L vs (35.72 ±2.62)g/L,P =0.006)]was decreased,plasma albumin loss from dialysis liquid[(6.41 ±1 .1 5)g/24h vs (5.51 ±1 .1 8)g/24h,P =0.008]was increased and IVST[(1 1 .67 ±1 .1 4) mm vs (1 0.96 ±0.97)mm,P =0.020],LVPWT[(1 0.1 6 ±0.93)mm vs (9.52 ±0.91 )mm,P =0.01 6]was thic-ker in H group.Univariate correlation analysis showed that peritoneal albumin loss was negatively correlated to both plasma-albumin and LVEF(r =-0.503,P <0.001 ;r =-0.406,P =0.003),and positively correlated to both IVST and LVPWT(r =0.442,P =0.001 ;r =0.328,P =0.01 8).Conclusion High permeability PD patients have signifi-cantly changed in left ventricular structure and cardiac injection function.Peritoneal albumin loss is correlated with cardiac structure and function of PD patients.