中国血液净化

中国血液净化 ›› 2012, Vol. 11 ›› Issue (05): 237-240.doi: 10.3969/j.issn.1671-4091.2012.05.00

• 临床研究 • 上一篇    下一篇

腹膜透析患者血白蛋白的季节性变化及其相关因素分析

李燕筠 左 力 甘红兵 董 捷   

  1. 北京大学第一医院肾内科
  • 收稿日期:2012-02-06 修回日期:1900-01-01 出版日期:2012-05-12 发布日期:2012-05-12
  • 通讯作者: 董捷 euyanjun@hotmail.com

Analysis of related factors for seasonal variation of serum albumin in patients on peritoneal dialysis

LI Yan-jun, ZUO Li, GAN Hong-bing, DONG Jie   

  • Received:2012-02-06 Revised:1900-01-01 Online:2012-05-12 Published:2012-05-12

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摘要： 【摘要】目的 观察腹膜透析患者血白蛋白水平的季节性变化，并对此现象的相关因素进行分析。方法在2006年9月至2007年8月期间纳入北京大学第一医院腹膜透析中心稳定透析的病例41例。随访期间每1～2月测定患者的血白蛋白水平，同时记录血白蛋白的可能影响因素，包括饮食蛋白质摄入及透析液和尿液中的总蛋白质丢失等。以上指标均按春、夏、秋、冬取季节平均值。结果患者年龄59.69±14.23岁，中位透析龄35.85月(6～104月)。经年龄、性别、透析龄、饮食蛋白质摄入及总蛋白质丢失校正后，患者血白蛋白存在季节性变化，其中夏季最低，冬季最高，分别为35.45±0.38g/L和37.19±0.39g/L(P＜0.001)。但是，患者的饮食蛋白质摄入及总蛋白质丢失未呈现季节性变化。将患者按年龄中位数分为2组，其中低龄组(年龄≤62岁)较高龄组(年龄＞62岁)患者血白蛋白的季节性变化趋势更明显(P＜0.05)，血白蛋白最高值与最低值的差值分别为2.35g/L和1.20g/L。 结论 腹膜透析患者血白蛋白的季节性变化不能用饮食蛋白质摄入及蛋白质丢失的变化来解释。年龄小于62岁的腹膜透析患者血白蛋白的季节性变化趋势更为明显。这些现象的发生机制有待进一步探讨。

关键词: 腹膜透析, 血白蛋白, 季节性变化

Abstract: 【Abstract】Objectives To observe the seasonal variation of serum albumin in peritoneal dialysis patients, and to analyze its related factors including dietary protein intake and protein loss. Methods We enrolled 41 clinically stable patients on peritoneal dialysis in our Peritoneal Dialysis Center between Sep. 2006 and Aug. 2007. Serum albumin, dietary protein intake and protein loss through urine and dialysate were recorded every one to two months, and the average values in the four seasons were calculated. Results Forty-one patients with the age of 59.69±14.23 yrs and with the dialysis duration of 35.85 months (6-104 month) were enrolled. The seasonal variation of serum albumin was obtained after adjusted for age, sex, dialysis duration, protein intake and total protein loss, with the nadir value in summer (35.45±0.38g/l) and peak value in winter (37.19±0.39g/l; P＜0.001, compared with the value in summer). There were no significant differences in the changes of dietary protein intake and total protein loss throughout the year. Next, we divided patients into two groups according to the median of age. The seasonal variation of serum albumin was more obvious in lower age group (age ≤ 62 years) than in elder age group (P＜0.05), and the differences in serum albumin in cold and warm season were 2.35g/l and 1.20g/l, respectively. Conclusions The seasonal variation of serum albumin in peritoneal dialysis can not be explained by the changes of dietary protein intake and protein loss. The extent of seasonal variation in serum albumin was more obvious in patients less than 62 yrs. The mechanism underlying these phenomena remains to be further explored.

Key words: Peritoneal dialysis, Albumin, Seasonal variation