腹膜转运类型对腹膜透析患者B型脑钠肽和心脏结构及功能的影响

目的探讨腹膜透析患者腹膜转运类型和B型脑钠肽（B-typenatriureticpeptide，BNP）及心脏结构与功能的关系。方法腹膜透析患者64例，根据腹膜平衡试验结果分为高转运组39例与低转运组25例，比较2组患者透析时间、合并糖尿病、高血压比例，检测2组血白蛋白、血红蛋白、血尿素氮、肌酐与BNP值，彩超测定患者左心房前后径、左心室前后径、室间隔厚度、左心室后壁厚度及左室射血分数，并进行比较。结果高转运组合并糖尿病比例、室间隔厚度、BNP均值（64．1％，（11．16±1．10）mm，578ng／L）高于低转运组（36．0％，（10．22±1．23）mm，312ng／L）（P〈0．05），白蛋白、左室射血分数（（32．51±4．95）g／L，（59．85±5．10）％）低于低转运组（（35．95±4．84）g／L，（62．48±5．05）％）（P〈0．05）。结论与低转运类型腹膜透析患者相比，高转运类型腹膜透析患者容量负荷较高，心脏功能与营养状况较差；糖尿病患者腹膜转运类型多为高转运或高平均转运型。

Influence of peritoneal transport characteristics on B-type natriuretic peptide and cardiac function and structure in peritoneal dialysis patients

Objective To study the relationship of peritoneal transport type with B-type natriuretic peptide （BNP） and cardiac structure and function in peritoneal dialysis （PD） patients. Methods Sixty-four PD patients were divided into high transport group （n= 39） and low transport group （n= 25） according to peritoneal equilibration test. The dialysis time, and proportion of diabetes mellitus and hypertension were compared between two groups. The serum albumin, hemoglobin, blood urea nitrogen, creatinine and BNP were detected. The left atrial diameter, left ventricular diameter, interventricular septal thickness, left ventricular posterior wall thickness and left ventricular ejection fraction were measured by echocardiography and compared between two groups. Results The proportion of diabetes mellitus, interventricular septal thickness and BNP value were 64.1%, （11. 16± 1.10） mm and 578 ng/L in high transport group, significantly higher than those in low transport group （36.0%, （10. 22±1.23） ram, 312 ng/L） （P〈0.05）. The level of albumin and left ventricular ejection fraction were （32.51±4.95） g/L and （59.85 ± 5. 10） % in high transport group, significantly lower than those in low transport group （（35.95±4.84）g/L, （62.48±5.05）% （P〈0.05）. Conclusions Compared with low transport PD patients, the volume load is higher, and the cardiac function and nutritional status are worse in high-transport PD patients. Transport type and high average transport type are the main types of peritoneal transport in PD patients with diabetes mellitus.