连续性非卧床腹膜透析患者腹膜转运类型与营养状况的关系

目的 探讨连续性非卧床腹膜透析(CAPD)患者腹膜转运类型与营养状况之间的关系.方法 选取106例CAPD患者为研究对象,根据腹膜转运功能分为高转运组(H组)和低转运组(L组),再根据总的尿素清除率(Kt/V)和总肌酐清除率(Ccr)分为透析充分组(HA组、LA组)和透析不充分组(HI组、LI组),根据蛋白质呈现率(nPNA)、清蛋白、主观综合评价法(SGA)对患者的营养状况进行评估.结果 H组和L组患者的营养不良发生率间差异有统计学意义(P＜0.01);Kt/V与血清蛋白、nPNA均呈正相关(P＜0.05);H组与L组的总Kt/V、总肌酐清除率、血清蛋白、透析液清蛋白间差异均有统计学意义(P＜0.05),而nPNA间差异无统计学意义(P＞0.05).结论 腹膜透析高转运类型者较低转运者营养状况差,但高转运者中Kt/V达标者的营养状态较未达标者明显改善.

Peritoneal Transport and Nutrition Condition in Patients Receiving Continuous Ambulatory Peritoneal Dialysis

Objective To investigate the relationship between peritoneal transport type and nutrition condition in patients who are given continuous ambulatory peritoneal dialysis(GAPD).Methods One hundred and six GAPD patients were enrolled.According to the function of peritoneal transport they were divided as high transport group(H) and low transport group.Then they were further categorized according to urea clearance(Kt/v) and creatinine clearance(Ccr) as adequacy(HA,LA) and inadequacy(HI,LI) groups.The nutrition conditions of the patients were assessed by protein nitrogen appearance,serum albumin level and subjective global assessment(SGA).Results There was a significant difference in prevalence of malnutrition between the H and L group(P<0.01);Kt/v was positively correlated with serum albumin and nPNA levels(P<0.05);Between H group and L group,there were significant differences in levels of Kt/v,Ccr,serum albumin and dialysis albumin(P<0.05),but no significant difference in nPNA found.Conclusion The patients with high transport peritoneal membrane are poorer in nutrition condition than those with low transport peritoneal membrane,and those with high transport peritoneal membrane whose Kt/v gets to the standard have an markedly improved condition of nutrition.