中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (08): 531-535.doi: 10.3969/j.issn.1671-4091.2021.08.007

• 临床研究 • 上一篇    下一篇

腹膜透析患者的腹腔压力与腹膜转运功能的相关性研究

刘春芳1,刘思远1,尚玉1,纪天蓉1,孔凡武1   

  1. 1哈尔滨医科大学附属第二医院肾内科
  • 收稿日期:2021-02-04 修回日期:2021-05-31 出版日期:2021-08-21 发布日期:2021-08-05
  • 通讯作者: 孔凡武 kidney1979@163.com E-mail:kidney1979@163.com
  • 基金资助:
    中国博士后科学基金(2017M610213)；黑龙江省博士后科学基金(LBH-Z18128)

The interaction between intraperitoneal pressure and peritoneal transport function in peritoneal dialysis patients

  1. 1Department of Nephrology, The Second Affiliated Hospital, Harbin Medical University, Harbin 150000, China
  • Received:2021-02-04 Revised:2021-05-31 Online:2021-08-21 Published:2021-08-05
  • Contact: FANWU KONG E-mail:kidney1979@163.com

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摘要： 【摘要】目的探究腹膜透析(peritoneal dialysis, PD)患者的腹腔压力(intraperitoneal pressure，IPP)与腹膜转运功能的相关因素。方法纳入2020 年8 月～2021 年1 月在在哈尔滨医科大学附属第二医院行腹膜平衡试验(peritoneal equilibration test,PET)的50 例PD 患者的临床资料。根据测得的患者IPP 值和PET 结果4h 透析液肌酐与血肌酐浓度的比值(dialysate/plasma creatinine，D/Pcr值)将患者分别进行分组，比较各组间的患者基本特征和实验室指标的差异，并进行相关性分析。结果①高腹压组体质量指数(BMI)、D/Pcr 和腹围明显高于正常稍高腹压组、正常稍低腹压组(F 值分别为12.442，4.582，14.090；P 值分别为0.023，0.037，0.001)。高转运组BMI(F=3.226，P=0.033) 和IPP(F=8.816，P=0.018)明显高于高平均转运组、低平均转运组和低转运组。②Spearman 秩相关分析显示，IPP 与体质量(r=0.766，P=0.002)、BMI(r=0.849，P=0.023)、D/Pcr(r=0.658，P=0.037)、腹围(r=0.855，P=0.001)呈正相关；D/Pcr 值与BMI(r=0.636，P=0.033)、IPP(r=0.647，P=0.018)两者呈正相关，与高密度脂蛋白(HDL)(r=-0.121，P=0.013)呈负相关。③Logistic 回归分析显示，BMI(OR=0.083，95% CI：0.485～0.924，P=0.043)、体质量(OR=0.796，95% CI：0.669～946，P=0.010)和腹围(OR=0.717，95% CI：0.544～0.945，P=0.018)是高腹腔压力的独立危险因素；BMI(OR=0.696，95% CI：0.495～0.979，P=0.037)、体质量(OR=0.918，95% CI：0.843～1.000，P=0.049)和IPP(OR=0.728，95% CI：0.524～1.010，P=0.047)是影响腹膜高转运功能的独立危险因素。结论①PD 患者的IPP 与腹膜转运功能密切相关，相互促进。②BMI、腹围和体质量或许是预估患者IPP 的参考指标，BMI、IPP 和体质量可能成为预判PD 患者腹膜转运类型的潜在临床指标。

关键词: 腹膜透析, 腹膜转运功能, 腹腔压力

Abstract: 【Abstract】Objectives To explore the interaction between intraperitoneal pressure (IPP) and peritoneal transport function changes in peritoneal dialysis (PD) patients. Methods A total of 50 PD patients undergoing peritoneal equilibration test (PET) in the Second Affiliated Hospital, Harbin Medical University during August 2020 to January 2021 were enrolled in this study. Their clinical data were recruited. They were divided into groups based on the results of IPP and PET and the creatinine ratio of dialysate (4 hours)/plasma (D/Pcr). Clinical data and laboratory results were compared between groups. Correlation analyses were also carried
out. Results ①BMI (F=12.442, P=0.023), waist circumference (F=14.090, P=0.001) and D/Pcr (F=4.582, P=0.037) were significantly higher in the high IPP group than in the moderate high IPP but within range group and the low IPP but within normal range group. In addition, BMI (F=3.226, P=0.033) and IPP (F=8.816, P=0.018) were significantly higher in the high transport group than in the high average transport group, the low average transport group and the low transport group. ②Spearman correlation analysis showed that IPP was positively correlated with body weight (r=0.766, P=0.002), BMI(r=0.849, P=0.023), D/Pcr (r=0.658, P=0.037) and waist circumference (r=0.855,P=0.001); D/Pcr was positively correlated with BMI (r=0.636, P=0.033), IPP (r=0.647, P=0.018) and was negatively correlation with HDL (r=-0.121, P=0.013). ③Logistic regression analysis showed that BMI (OR=0.083, 95% CI: 0.485~0.924, P=0.043), body weight (OR=0.796, 95% CI: 0.669~ 946, P=0.010) and waist circumference (OR=0.717, 95% CI: 0.544~0.945, P=0.018) were the independent risk factors for high IPP; BMI (OR=0.696, 95% CI: 0.495~0.979, P=0.037), body weight (OR=0.918,95% CI：0.843~1.000, P=0.049) and IPP (OR=0.728, 95% CI：0.524 ~ 1.010, P=0.047) were the independent risk factors for peritoneal transport function. Conclusions ① IPP and peritoneal transport function were closely related and affected each other. ②BMI, waist circumference and body weight may be the indicators for predicting IPP in PD patients; BMI, IPP and body weight may be used as the indicators for predicting peritoneal transport type in PD patients.

Key words: Peritoneal dialysis, Peritoneal transport function, Intraperitoneal pressure

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