CAPD病人血清半胱氨酸浓度与营养状况的探讨

目的 连续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)病人营养状况是影响病人存活率的重要因素之一,病人的营养状况与血清半胱氨酸(tHcy)浓度存在正相关性。本研究旨在探讨血清tHcy浓度在CAPD病人营养评估中的价值。方法 慢性肾功能不全(CRF)病人35例,健康志愿者50例为对照组。应用临床综合营养指数(Composite Nutritional Index,CNI)评估CAPD病人的营养状况,用高效液相法测定血清tHcy浓度。结果 CRF病人CAPD治疗前血清tHcy浓度与健康对照组无显著差别(P>0.05),CAPD治疗6个月后血清tHcy浓度较健康对照组明显增高(P<0.001),CAPD病人伴有心、脑血管病变者血清tHcy浓度较无心、脑血管病变者明显减低(P<0.01)。血清tHcy浓度与CNI呈负相关(R2~=0.5991)。结论 CAPD病人血清tHcy浓度与病人营养状况呈正相关。

Plasma homocysteine and it's relationship with nutrition status in patients treated with continuous ambulatory peritoneal dialysis

Objective Nutritional status is one of the important factors in long term continuous ambulatoiy peritoneal dialysis (CAFD) prognoses. And there is a positive relationship between total plasma hemocvsteine (tHcy) and patients' nutritional status. This study was designed to assess the possible value of tHcy as an indicator of the nutrition status of CAPD patients. Methods Total 35 patients maintained on CAPD were evaluated. 50 healthy volunteers were tested as control. Nutritional status was assessed by Composite Nutritional Index(CNI). The Ievel of tHcy was determined with high - performance liquid chromatography. Results There was no difierence of tHcy between conservative management patients and healthy controls(P > 0.05) . The level of tHcy was significant-ly elevated in patients treated with CAPD for 6 months compared with healthy controls (P < 0.001), and CAPD patients without cardiovascular disease compared with cardiovascular patients( P < 0.01) . The Ievel of tHcy correlated negatively with CNI (R2 = 0.5991). Conclusions Our results suggested that the level of tHcy relate positively with CAPD patients' nutrition status.