持续性非卧床腹膜透析患者的临床特征及影响腹膜转运功能的相关因素

目的：观察不同腹膜转运类型的持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis，CAPD)患者的临床特征，探讨影响腹膜转运功能的相关因素。方法：回顾性总结158例CAPD患者的临床资料，根据腹膜平衡试验评价患者的腹膜转运功能并将其分为高平均转运+高转运组(A组，n=84)和低平均转运+低转运组(B组，n=74)，并对两组患者的人口学资料、临床生物化学指标以及心血管并发症情况进行比较；应用logistic回归分析寻找影响患者腹膜转运功能的相关因素。结果：B组患者血清白蛋白(albumin，ALB)水平显著高于A组(P<0.05)。A组患者的4 h透析液肌酐与血肌酐浓度的比值(dialysate/plasma creatinine，D/Pcr)、超敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)、体重指数(body mass index，BMI)及心血管并发症的发生率均显著高于B组(均P<0.05)。相关分析显示：D/Pcr与BMI，hs-CRP和心血管并发症呈正相关(分别r=0.179，0.373和0.426，均P<0.05)；与ALB呈负相关(r=–0.393，P<0.01)。Logistic回归分析显示：高BMI(OR=1.178，P<0.05)、心血管并发症(OR=5.035，P<0.01)以及低血清ALB(OR=0.852，P<0.01)为患者腹膜高转运的危险因素。结论：腹膜透析患者血清ALB水平、BMI和心血管并发症与腹膜高转运相关，可作为预估患者腹膜转运功能的参考指标。

Clinical characteristics and the factors relevant toperitoneal transport function in patients with continuousambulatory peritoneal dialysis

Objective: To observe the clinical characteristics with different peritoneal transport type inpatients with continuous ambulatory peritoneal dialysis (CAPD), and to investigate the factorsassociated with peritoneal transport function.Methods: The clinical data of 158 CAPD patients were analyzed retrospectively. According toperitoneal equilibration test, a method for evaluation of the peritoneal transport function, thepatients were divided into 2 groups: a high average and high peritoneal transport group (Group A,n=84) and a low average and low peritoneal transport group (Group B, n=74). The demographics,clinical biochemical indexes and the incidence of cardiovascular complications were comparedbetween the 2 groups. Logistic regression analysis was used to find the factors relevant to peritonealtransport function.Results: The level of serum albumin (ALB) in the Group B was significantly higher than that in theGroup A (P<0.05). The 4 h dialysate/plasma creatinine (D/Pcr), high-sensitivity C-reactive protein(hs-CRP), body mass index (BMI), and the rates of cardiovascular complications in the Group Awere significantly higher than those in the Group B (P<0.05). Correlation analysis showed that theD/Pcr was positively correlated with the BMI, serum hs-CRP and cardiovascular complications(r=0.179, 0.373 and 0.426, respectively, P<0.05), while it was negatively correlated with ALB(r=–0.393, P<0.01). Logistic regression analysis showed that the high BMI (OR=1.178, P<0.05),cardiovascular complications (OR=5.035, P<0.01), and the low serum ALB (OR=0.852, P<0.01)were the risk factors for high peritoneal transport.Conclusion: The serum ALB level, BMI and the cardiovascular complications are associated withhigh peritoneal transport, which are useful markers for predicting the peritoneal transport functionbefore peritoneal dialysis.