腹膜透析患者左心室肥厚与腹膜转运特性的关系

目的 探讨腹膜透析患者左心室肥厚与腹膜转运特性的关系.方法 69例持续性不卧床腹膜透析（CAPD）患者,超声心动图检查测算左心室心肌质量指数（LVMI）,应用改良腹膜平衡试验（PET）,按患者腹膜转运类型分高转运组、高平均转运组、低平均转运组及低转运组,同时检测血红蛋白、血白蛋白、尿素氮、肌酐等,以及测定尿素清除指数（Kt/V）和肌酐清除率（Ccr）,记录透析龄、收缩压、舒张压.结果 腹膜高转运和高平均转运例数比低转运和低平均转运多（41/28）;高转运组、高平均转运组、低平均转运组、低转运组透析龄分别为（39.2±21.8）、（26.6±15.6）、（28.6±14.4）、（45.7±35.0）岁,4组间差异有统计学意义（F=4.128,P＜0.05）,高转运组透析龄比高平均转运组、低平均转运组长（P均＜0.05）,低转运组透析龄比高平均转运组、低平均转运组长（P均＜0.05）;LVMI与4h透析液肌酐与血肌酐比值（D/Pcr）、收缩压、舒张压呈正相关（r值分别为0.339、0.351、0.316,P均＜0.01）,与白蛋白呈负相关（r=-0.292,P＜0.05）;69例CAPD患者发生左心室肥厚44例,发生率63.8％,高转运组高于低平均转运组及低转运组（x2值分别为5.455、5.091,P均＜0.05）.结论 维持性腹膜透析患者高转运特性占大多数,有较高左心室肥厚发生率,高转运者更为明显.D/Pcr、收缩压、舒张压升高和低白蛋白与左心室肥厚密切相关.

Association between left ventricular hypertrophy and peritoneal transport properties in peritoneal dialysis patients

Objective To investigate the association between left ventricular hypertrophy and peritoneal transport properties in Peritoneal Dialysis patients.Methods Sixty-nine Continuous Ambulatory Peritoneal Dialysis （CAPD）patients were enrolled in current study.All patients underwent echocardiography for left ventricular mass index （LVMI）.Transport status was categorized as high transport,high average transport,low average transport and low transport based on modified peritoneal equilibration test （PET）.The data collected included hemoglobin,albumin,blood urea nitrogen,creatinine,urea clearance （Kt/V） and creatinine clearance rate （Ccr）,dialysis vintage,systolic blood pressure,diastolic blood pressure.Results Patients with high transport status were 41 cases,more than those with low transport status（28 cases）.The dialysis age of high transport,high average transport,low average transport and low transport vintage were （39.2 ± 21.8）,（26.6 ±15.6）,（28.6 ± 14.4）,（45.7 ± 35.0） years old respectively,and the difference was significant （F =4.128,P ＜ 0.05）.The dialysis age in the higher transport group was longer than that in high average transport group and low average transport group （P ＜ 0.05）.LVMI has significant positive correlations with D/Pcr at 4th hour,SBP and DBP （r =0.339,0.351,0.316,P ＜ 0.01） and the negative correlation with albmin （r =-0.292,P ＜0.05）.Left ventricular hypertrophy（LVH） in all patients was 63.8％,ant it was higher in high transport group than that low average transport and low transport group （x2 =5.455,5.091,P ＜ 0.05） Conclusion High transport status is the most common in CAPD patients.There is high incident rate of LVH in this population.LVH has significant positive correlations with D/Pcr,higher SBP,DBP,and lower albumin.