容量超负荷状态对持续性非卧床腹膜透析患者血清白蛋白水平的影响  

The Effect of Fluid Overload on Serum Albumin in Continuous Ambulatory Peritoneal Dialysis Patients

作　　者：陈立[1,2] 田信奎[1] 陈伯钧[2] 汪涛[1] 

机构地区：[1]北京大学第三医院肾内科,北京100191 [2]广东省中医院大学城医院急诊科,广州510120

出　　处：《中国中西医结合肾病杂志》2010年第9期786-789,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：北京市科技计划项目(No.66474-01);中华人民共和国教育部长江学者奖励计划;教育部振兴行动计划专项基金资助项目(No.985程)

摘　　要：目的:探讨容量超负荷状态对持续性非卧床腹膜透析(CAPD)患者血清白蛋白(Alb)水平的影响。方法:对2009年6月在北京大学附属第三医院肾内科接受持续性非卧床腹膜透析患者进行横断面调查。采用BCM系统测定患者体成份,并以OH(overhydration)作为容量状态的评估指标;同时收集空腹血、24 h尿液及透析引流液用于透析充分性评估、Alb及其他生化检测。采用均数比较及多因素分析等统计学方法探讨容量状态与Alb之间的关系。结果:共有129例符合条件的患者入选本研究。根据总体Alb平均水平将患者分为两组,即Alb≥39 g/L和Alb<39 g/L。结果显示前者OH及年龄平均水平均明显小于后者[OH,(1.75±1.60)vs(3.16±1.88)L,P<0.05;年龄,(58.1±14.2)vs(67.8±12.3)岁,P<0.05];多因素分析提示,在矫正性别、糖尿病后,OH与年龄是影响患者血清白蛋白水平的独立危险因素(R2=0.301,P<0.05)。结论:本研究表明容量超负荷是影响腹膜透析患者低白蛋白血症发生的独立危险因素,并且OH也许是评估腹膜透析人群容量状况的良好指标。Objective：To study the effect of fluid overload on serum albumin（Alb） in patients undergoing continuous ambulatory peritoneal dialysis（CAPD）.Methods：A cross-sectional study was performed in CAPD patients treated in the division of nephrology,Peking University Third Hospital in June 2009.We collected data including body composition measured by BCM（Body Composition Monitor）,volume status index expressed as OH（overhydration）,serum albumin concentration,and dialysis adequacy.Comparisons between groups and multivariate analysis were used to explore the relationship between the volume status and Alb.Results：129 patients were included in the present study.Patients were divided into two groups according to averaged level of Alb（39 g/L）.OH and age were significantly higher in patients who having averaged level of Alb less than 39 g/L than their counterparts[OH,（3.16±1.88） vs（1.75±1.60）L,P0.05;age,（67.8±12.3） vs（58.1±14.2） year,P0.05].Multivariate analysis further showed that OH and age were independent risk factors affecting the level of Alb after adjusting for sex and diabetic status（R2=0.301,P0.05）.Conclusion：This study shows that volume overload is an independent risk factor of hypoalbuminemia in CAPD patients.It also indicates that OH may be a better indicator of volume status in CAPD patients.

关 键 词：容量状态 OH 血清白蛋白 持续性非卧床腹膜透析 

分 类 号：R459.5[医药卫生—治疗学]