中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (07): 485-488.doi: 10.3969/j.issn.1671-4091.2014.07.001

• 临床研究 •    下一篇

探讨腹膜不同转运类型对腹膜透析患者的营养状况、炎症及心血管并发症的影响

陈娜,陈孟华   

  1. 宁夏医科大学总医院肾脏内科
  • 收稿日期:2014-05-04 出版日期:2014-07-12 发布日期:2014-07-12
  • 通讯作者: 陈孟华 nxchnmh@163.com E-mail:nxchenmh@163.com
  • 基金资助:

    "十二五"国家科技支撑计划项目课题（2011BAI10B08）

The influence of peritoneal transport types on nutrition status, inflammation and cardiovascular complications in peritoneal dialysis patients

  • Received:2014-05-04 Online:2014-07-12 Published:2014-07-12

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摘要： 【摘要】目的：探讨腹膜不同转运类型对腹膜透析患者的营养状况、炎症状态及心血管并发症的影响。方法：对101名慢性肾衰竭腹膜透析患者据腹膜PET试验进行分组，即A组为高转运；B组为高平均转运；C组为低平均转运；D组为低转运，对患者的营养状况、炎症状态及心血管并发症进行调查分析。结果：1、各组营养不良的发生率比较：①A组，营养不良者5例，营养不良的发生率为 62.5%；②B组，营养不良 25例，营养不良的发生率为58.1 %；③C组，营养不良14例，营养不良的发生率为35%；④D组，均为营养良好，营养不良的发生率为 0 %。各种腹膜不同转运类型的患者营养不良的发生情况差异具有显著性（P=0.003），其中低转运组营养状况最好，高转运组营养状况最差。2、腹膜转运类型与炎症的关系：与C组比较，A组、B组的超敏C反应蛋白水平更高（分别为P=0.020 、 P=0.021）。3、各组心血管并发症的发病率：①A组为：62.50%；②B组为：55.81%，③C组为47.5%；④D组为30%。心血管并发症的发生情况在四种腹膜转运类型中差异具有显著性（P=0.038），以高转运组发生率最高，低转运组发生率最低。4、Pearsons相关性分析显示：患者的腹膜转运类型与心血管并发症（R=0.268，P=0.007）和炎症状态（R=0.312，P=0.002）呈正相关，与SGA评估的营养状况（R=-0.348，P=0.000 ），具有负相关性。结论：腹膜转运特性与CAPD患者的营养状况、炎症状态及心血管并发症的发生密切相关，腹膜功能呈现高转运状态、同时合并有较差的营养状态时易发生MIA综合症。在临床工作中，应常规评估腹膜转运特性，及时调整治疗处方，有益于改善患者的营养状况、减少心血管疾病的发生。

关键词: 腹膜透析, 腹膜转运类型, 营养, 炎症, 心血管并发症

Abstract: Objective To investigate the influence of peritoneal transport types on nutrition status, inflammation and cardiovascular complications in peritoneal dialysis (PD) patients. Methods A total of 101 chronic renal failure patients on PD were divided into 4 groups according to the peritoneal PET, group A (high transport), group B (average high transport), group C (average low transport) and group D (low transport). The nutritional status, inflammation and cardiovascular complications of the PD patients in the 4 groups were investigated. Results ①The prevalence of malnutrition was 62.5% (n=5) in group A, 58.1 % (n=25) in group B, 35% (n=14) in group C, and 0% in group D. Therefore, the nutritional status was significantly different among PD patients with different peritoneal transport types (P=0.003), with the best in low transport group (group D) and the worst in high transport group (group A). ②As for inflammation, high-sensitivity C-reactive protein (hs-CRP) was higher in groups A and B as compared with that in group C (P=0.020 and 0.021, respectively). ③ The prevalence of cardiovascular complications was 62.50 %, 55.81%, 47.5%, and 30% in group A, B, C and D, respectively, significantly different among PD patients with different peritoneal transport types (P = 0.038) with the highest in group A and the lowest in group D. ④ Pearson’s correlation analysis showed that the degree of peritoneal transport was positively correlated with cardiovascular complications (r=0.268, P= 0.007) and hs-CRP (r=0.312, P=0.002) and was negatively correlated with the SGA score for nutritional status assessment (r=-0.348, P=0.000). Conclusion Peritoneal transport function closely relates to nutritional status, inflammation and cardiovascular complications. Poor nutritional status and MIA syndrome are frequently seen in PD patients with higher peritoneal transport. Clinically, adjustment of treatment regimen based on the results from routine evaluation of peritoneal transport function may be useful to improve nutritional status and reduce cardiovascular complications in PD patients.

Key words: Peritoneal dialysis, Peritoneal transport type, Nutritional, Inflammation, Cardiovascular complications