CAPD患者腹膜转运功能对患者生存率的影响  

Correlation of peritoneal transport function to survival rate of the patients with continuous ambulatory peritoneal dialysis

作　　者：郭王[1] 廖云[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国血液净化》2007年第9期487-489,495,共4页Chinese Journal of Blood Purification

摘　　要：目的了解腹膜透析开始时腹膜转运类型对连续非卧床腹膜透析(CAPD)患者生存率的影响。方法选择首都医科大学附属北京友谊医院透析时间大于3个月,且在开始腹膜透析的头3个月内接受了腹膜平衡试验(PET)的患者94名,并根据PET结果分为高转运(H)、高平均(HA)、低平均(LA)和低转运(L)4组,分析各组间残余肾功能、腹膜透析持续时间、腹膜透析对小分子溶质清除情况以及腹膜透析超滤情况的差异。结果在四组之间,残余肾功能差异没有显著性;在转运功能强的患者中总肌酐清除率较高,但腹膜透析超滤则低于转运功能弱的患者(P值均小于0.05)。在4组患者中,Kaplan-Meier法生存率分析显示累积生存率差异存在着显著性(?2=9.24,P=0.0262);且高转运和高平均组患者的生存率显著低于低平均组患者(P值分别为0.0026和0.0031)。结论腹膜转运功能强的CAPD患者,生存率低于转运功能弱的患者。这无法用小分子溶质的清除效率来解释,可能与转运功能弱的患者腹膜透析超滤效果较好有关。Objective To understand the influence of peritoneal transport function in patients at the beginning of continuous ambulatory peritoneal dialysis （CAPD） treatment on their survival rate. Methods We selected 94 CAPD patients who received CAPD for more than 3 months and examined the peritoneal equilibration test in the first 3 months of CAPD. Patients were then grouped into high transport group （H）, higher transport than average group （HA）, lower transport than average group （LA） and low transport group （L） based on the results of peritoneal equilibration test. Residual renal function, period of CAPD, clearance of creatinine （Ccr） and ultrafiltration function of the peritoneum were compared among the 4 groups. Results No significant difference in residual renal function existed among the 4 groups. Patients with higher peritoneal transport function showed higher Ccr （P 〈0.05） but less ultrafiltration function （P〈0.05）. Kaplan-Meier survival analysis revealed a significant difference in cumulative survival rate among the 4 groups, and the cumulative survival rate of group H and HA was lower than that of group LA （P=0.0026 and 0.0031, respectively）. Conclusion CAPD patients with higher peritoneal transport function have the survival rate less than those with lower transport function. This fact cannot be explained based on the difference of clearance efficiency of small molecule solutes, but may be related to the better ultrafiltration function of peritoneum in LA group.

关 键 词：腹膜透析 腹膜转运 腹膜平衡试验 生存率 

分 类 号：R692.5[医药卫生—泌尿科学]