中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
5期
457-460
,共4页
万美燕%夏平%于龙丽%崔永军%邹作君
萬美燕%夏平%于龍麗%崔永軍%鄒作君
만미연%하평%우룡려%최영군%추작군
糖尿病%腹膜通透性%心脏结构%心脏功能
糖尿病%腹膜通透性%心髒結構%心髒功能
당뇨병%복막통투성%심장결구%심장공능
Diabetes%Peritoneal transport type%Cardiac structure%Cardiac function
目的 比较糖尿病与非糖尿病不同腹膜通透性患者心脏结构和功能.方法 选择我中心随访的透析时间至6个月的非卧床腹膜透析(CAPD)患者84例,糖尿病患者46例,非糖尿病患者38例.根据腹膜平衡实验结果以透析液肌酐浓度(D)/血浆肌酐浓度(P)值(D/P＞0.65为高通透组,D/P≤0.65为低通透组)分组,分为糖尿病高通透组32例、糖尿病低通透组14例、非糖尿病高通透组12例、非糖尿病低通透组26例.检测患者透析前及透析6个月后肾功能与白蛋白,以超声多普勒测定患者透析前与透析6个月后左心房内径(LAD)、左心室内径(LVD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)及左心室射血分数(LVEF),不同组间进行比较.结果 透析治疗前,4组患者各指标差异均无统计学意义(P均＞0.05).透析6个月后,糖尿病低通透组、非糖尿病低通透组、糖尿病高通透组、非糖尿病高通透组白蛋白[(36.57 ±3.34)、(37.21 ±4.12)、(34.19±3.98)、(34.51 ±4.52) g/L,F=9.034)]、IVST[(10.45 ±1.12)、(10.17 ±1.35)、(11.32±1.09)、(11.46±1.38) mm,F=7.525]、LVPWT[(9.58±1.42)、(9.47±1.31)、(10.71±1.40)、(10.15±1.41) mm,F=4.963]及LVEF[(63.98±4.73)％、(63.92±5.17)％、(60.12±5.12)％、(61.43±5.57)％,F=6.984]差异有统计学意义(P均＜0.05).与糖尿病高通透组和非糖尿病高通透组相比,糖尿病低通透组和非糖尿病低通透组以上指标均有统计学意义(P均＜0.05).结论 糖尿病患者腹膜功能多为高通透性,腹膜高通透性是影响患者心脏功能的重要因素.
目的 比較糖尿病與非糖尿病不同腹膜通透性患者心髒結構和功能.方法 選擇我中心隨訪的透析時間至6箇月的非臥床腹膜透析(CAPD)患者84例,糖尿病患者46例,非糖尿病患者38例.根據腹膜平衡實驗結果以透析液肌酐濃度(D)/血漿肌酐濃度(P)值(D/P＞0.65為高通透組,D/P≤0.65為低通透組)分組,分為糖尿病高通透組32例、糖尿病低通透組14例、非糖尿病高通透組12例、非糖尿病低通透組26例.檢測患者透析前及透析6箇月後腎功能與白蛋白,以超聲多普勒測定患者透析前與透析6箇月後左心房內徑(LAD)、左心室內徑(LVD)、室間隔厚度(IVST)、左心室後壁厚度(LVPWT)及左心室射血分數(LVEF),不同組間進行比較.結果 透析治療前,4組患者各指標差異均無統計學意義(P均＞0.05).透析6箇月後,糖尿病低通透組、非糖尿病低通透組、糖尿病高通透組、非糖尿病高通透組白蛋白[(36.57 ±3.34)、(37.21 ±4.12)、(34.19±3.98)、(34.51 ±4.52) g/L,F=9.034)]、IVST[(10.45 ±1.12)、(10.17 ±1.35)、(11.32±1.09)、(11.46±1.38) mm,F=7.525]、LVPWT[(9.58±1.42)、(9.47±1.31)、(10.71±1.40)、(10.15±1.41) mm,F=4.963]及LVEF[(63.98±4.73)％、(63.92±5.17)％、(60.12±5.12)％、(61.43±5.57)％,F=6.984]差異有統計學意義(P均＜0.05).與糖尿病高通透組和非糖尿病高通透組相比,糖尿病低通透組和非糖尿病低通透組以上指標均有統計學意義(P均＜0.05).結論 糖尿病患者腹膜功能多為高通透性,腹膜高通透性是影響患者心髒功能的重要因素.
목적 비교당뇨병여비당뇨병불동복막통투성환자심장결구화공능.방법 선택아중심수방적투석시간지6개월적비와상복막투석(CAPD)환자84례,당뇨병환자46례,비당뇨병환자38례.근거복막평형실험결과이투석액기항농도(D)/혈장기항농도(P)치(D/P＞0.65위고통투조,D/P≤0.65위저통투조)분조,분위당뇨병고통투조32례、당뇨병저통투조14례、비당뇨병고통투조12례、비당뇨병저통투조26례.검측환자투석전급투석6개월후신공능여백단백,이초성다보륵측정환자투석전여투석6개월후좌심방내경(LAD)、좌심실내경(LVD)、실간격후도(IVST)、좌심실후벽후도(LVPWT)급좌심실사혈분수(LVEF),불동조간진행비교.결과 투석치료전,4조환자각지표차이균무통계학의의(P균＞0.05).투석6개월후,당뇨병저통투조、비당뇨병저통투조、당뇨병고통투조、비당뇨병고통투조백단백[(36.57 ±3.34)、(37.21 ±4.12)、(34.19±3.98)、(34.51 ±4.52) g/L,F=9.034)]、IVST[(10.45 ±1.12)、(10.17 ±1.35)、(11.32±1.09)、(11.46±1.38) mm,F=7.525]、LVPWT[(9.58±1.42)、(9.47±1.31)、(10.71±1.40)、(10.15±1.41) mm,F=4.963]급LVEF[(63.98±4.73)％、(63.92±5.17)％、(60.12±5.12)％、(61.43±5.57)％,F=6.984]차이유통계학의의(P균＜0.05).여당뇨병고통투조화비당뇨병고통투조상비,당뇨병저통투조화비당뇨병저통투조이상지표균유통계학의의(P균＜0.05).결론 당뇨병환자복막공능다위고통투성,복막고통투성시영향환자심장공능적중요인소.
Objective To compare the cardiac structure and function between diabetic and non-diabetic with different peritoneal transport type.Methods A total of 84 patients with continuous ambulatory peritoneal dialysis (CAPD) in our center for 6 months were enrolled in this study.Forty-six patients of subjects were diabetic,another 38 were non-diabetic.Patients were divided into four groups according to the results of peritoneal equilibration test (PET) and the ratio of creatinine concentration in dialysate solution and plasma (D/P creatinine concentration).Patients with D/P creatinine concentration ＞ 0.65 were with high permeability and otherwise were low permeability.The four groups were diabetic-H (high permeability) group,diabetic-L(low permeability) group,non-diabetic-H (high permeability) group,non-diabetic-L (low permeability) group.The levels of left atrial diameter (LAD),left ventricular diameter(LVD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF) were measured before and after 6-month peritoneal dialysis by ultrasonic doppler.Results Before peritoneal dialysis,there were no significant difference in the terms of all parameters among four groups(P ＞0.05).After 6 months of peritoneal dialysis,the albumin levels,IVST,LVPWT and LVEF in diabetic-L group,non-diabetic-L,diabetic-H group and non-diabetic-H group were ((36.57 ± 3.34),(37.21 ± 4.12),(34.19 ± 3.98),(34.51 ± 4.52) g/L respectively;F =9.034),((10.45 ± 1.12),(10.17 ± 1.35),(11.32 ± 1.09),(11.46 ± 1.38) mm respectively;F =7.525),((9.58 ± 1.42),(9.47 ± 1.31),(10.71 ± 1.40),(10.15 ± 1.41) mm respectively; F =4.963) and ((63.98 ± 4.73) ％,(63.92 ± 5.17) ％,(60.12 ± 5.12) ％,(61.43 ± 5.57) ％respectively ;F =6.984),and the differences were statistic significant (P ＜ 0.05).Compared to diabetic-H group and non-diabetic-H group,there were significant difference in the terms of all above indexes between diabetic-L group,non-diabetic-L (P ＜ O.05).Conclusion The peritoneal transport.type of diabetic patients is high permeability,which might be an important factor affecting cardiac complications in patients.
