CAPD患者腹腔局部防御功能与营养状况的研究  

Local defence of the abdominal cavity and nutritional state in CAPD patients

作　　者：张蕊[1] 任野平[1] 张庆芳[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院肾内科,黑龙江哈尔滨150086

出　　处：《哈尔滨医科大学学报》2005年第5期438-440,448,共4页Journal of Harbin Medical University

摘　　要：目的探讨持续性不卧床腹膜透析(CAPD)患者腹腔局部防御功能与营养不良的关系.方法记录41例规律CAPD患者的一般资料和透析处方.测定或计算营养指标:血白蛋白(ALB)、前白蛋白(PA)和转铁蛋白(TF);瘦体重(LBM),瘦体重%(LBM%)和标准化总氮出现率相当蛋白(nPNA).进行主观综合性营养评估(SGA).测定慢性炎症指标:腹透液中白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α).结果本组CAPD患者血清ALB为(34.15±7.36)g/L,TF为(2.20±0.45)g/L,二者均低于临床标准,腹透液IL-6浓度为(24.67±12.92)pg/ml,TNF-α浓度为(34.53±10.98)pg/ml,二者与腹透液葡萄糖浓度、交换量、交换次数、留腹时间、腹膜炎发作次数及GFR无相关性.在各营养不良组中,均至少有一个炎症指标显著性升高(P<0.01～0.05).在营养指标中,SGA与血ALB、血TF及LBM%呈显著正相关.结论 CAPD患者腹腔内存在慢性炎症状态,其与营养不良有密切关系.SGA是评估CAPD患者营养状况的良好指标.Objective To identify the relationship of local defence of abdominal cavity and malnutrition in continuous ambulatory peritoneal dialysis （CAPD） patients. Methods Common data and dialysis regime in 41 clinically stable CAPD patients were investigated. The serum albumin （ALB）, prealbumin （PA）, transferring （TF）, Lean body mass（LBM）, LBM% and the normalized protein equivalent of total nitrogen appearanee（nPNA） were examined or calculated. Subjective global assessment （SGA） was also evaluated. Effluent interleukin-6 （IL-6） and tumor necrotic factor-α（TNF-α） were measured as markers of chronic inflammation. Results Serum ALB and TF levels of CAPD cases were （34.15±7.36）g/L and （2.20±0.45）g/L, which were lower than the normal level. Effluent IL-6 and TNF-α levels were （24.67±12.92）pg/ml and （34.53 ±10.98）pg/ml, which were not correlated with glucose concentrition, amount and frequency of exchange, staytime, abdominal infection and glomendar filtration rate（GFR）. At least one marker of chronic inflammation in malnourished patients increased significantly （P〈0.01-0.05）. SGA were positively correlated with serum ALB, TF and LBM%. Conclusion Chronic inflammatory state is present in abdominal cavity of CAPD patients, which is closely related to malnutrition. SGA is a good index in evaluation of nutritional state in CAPD patients.

关 键 词：腹膜透析 营养不良 腹透液 局部防御 慢性炎症状态 

分 类 号：R459.5[医药卫生—治疗学]