重新评价腹膜平衡试验以确定腹膜透析患者的溶质转运类型

目的 确定由Twardowski提出的腹膜平衡试验（PET）的转运类型评判值是否适合本中心患者。方法 选取我院自1995年来首次进行PET测试的患者158例。首先依据Twardowski的评判标准（值）判断患者的转运类型,再根据本组患者实际4hD/Pcr的χ±s来确定患者的溶质转运类型,然后将患者重新分组:按两种数值均符合高转运为H1组,均符合平均转运为A组,均符合低转运为L1组,部分高转运患者经重新评价后符合平均转运为H2组,部分平均转运患者经重新评价后符合低转运为L2组。通过与临床情况（溶质和水的清除）进行对照,以进一步评价更适合本中心患者的评判标准。结果 按照Twardowski的标准,高转运、高平均转运、低平均转运及低转运患者的比例分别为21.5％、44.9％。27.8％及5.7％。本研究患者群中4hD/Pcr的均值和标准差为0.70和0.14,据此重新评判后,各组的比例分别为14.6％、33.5％、33.5％及18.4％。经与临床结果相对比,L2组对水份的清除能力明显高于A组（P<0.005）,与L1组差别无显著性意义。结论4hD/Pcr在不同的地区和人群中表现出不同的均数和标准差值,因而产生了不同的腹膜转运类型。根据本中心患者人群确定的值更适合本中心患者的临床情况。

Re-evaluation of solute transport groups of peritoneal dialysis patients using peritoneal equilibration test

Objective To clarify whether the peritoneal equilibration test (PET)-determined solute transport groups defined by Twardowski fits patients in our medical center. Methods 158 initial standardized PET data since 1995 was selected and proportions of four transport groups were calculated according to Twardowski's criterion. Using the mean and standard deviations of 4-hour dialysis/plasma ratio of creatinine (D/Pcr), transport groups of our patients were re-determined. Patients were classified as follow: according to both two criteria, patients whose 4-hour D/Pcr in the range of high transport, low transport and average transport were classified as group H1, group L1 and group A, respectively; several average transport patients who changed to low transport after re-evaluation were classified as group L2; high transport patients who changed to average transport were classified as group H2. Every group was compared with clinical status in order to evaluate which criterion fit our patients. Results The 4-hour D/Pcr was 0. 70 ?0. 14 in our patients. The proportion of high, high-average, low-average and low transport were 21.5%, 44.9%, 17.8% and 5. 7% according to Twardowski's and 14. 6% , 33.5%, 33.5% and 18. 4% after re-evaluation. The ultrafiltration volume in group L2 was significantly higher than that in group A ( P < 0. 005), as same as group L1. Conclusions 4-hour D/Pcr varies in different centers and in different patient groups. Transport characteristics after re-evaluation are more identical with clinical status.