胰岛素样生长因子-1与腹膜透析患者营养状况  

Insulin like growth factor-1 and nutritional condition of patients with peritoneal dialysis

作　　者：袁群英[1] 陈伟英[1] 李惠群[1] 郑志华 叶任高[1] 陆才生[1] 彭文兴[1] 

机构地区：[1]中山医科大学附属第一医院肾内科卫生部肾脏病临床研究重点实验室,广州510080

出　　处：《中华肾脏病杂志》1999年第6期354-357,共4页Chinese Journal of Nephrology

摘　　要：目的　（１）探讨胰岛素样生长因子１（ＩＧＦ１） 与腹膜透析营养状况的关系。（２） 探讨透析充分性、腹膜转运特性、残余肾功能对腹膜透析患者营养状况和血胰岛素样生长因子１ 水平的影响。方法　收集３６ 例持续性不卧床腹膜透析（ＣＡＰＤ）患者，采血测ＢＵＮ、Ｃｒ、白蛋白、补体、转铁蛋白、ＩＧＦ１，并纪录身高、体重对患者进行营养评估。测定残余肾功能、２４ 小时透析液肌酐与血肌酐浓度比值（Ｄ／Ｐ） 、总肌酐清除率（Ｔｃｒ）、尿素清除指数（Ｋｔ／Ｖ）。结果　（１） 患者血ＩＧＦ１ 水平与白蛋白、转铁蛋白、补体密切相关，血白蛋白高者ＩＧＦ１ 水平亦高。（２）Ｔｃｒ≥６０ Ｌ·周－１·（１．７３ｍ２）－１ 组ＩＧＦ１、转铁蛋白、白蛋白显著高于Ｔｃｒ＜６０ Ｌ·周－１·（１－７３ｍ２） －１组。Ｄ／Ｐ≥０－８１ 组白蛋白显著低于０－６５≤Ｄ／Ｐ＜ ０－８１、Ｄ／Ｐ＜ ０－６５ 组。残余肾功能高于２ ｍｌ／ｍｉｎ 组ＩＧＦ１、白蛋白水平显著高于残余肾功能小于２ｍｌ／ｍｉｎ 组。结论　（１）ＩＧＦ１ 是评价腹膜透析营养状况的早期敏感指标。（２） 透析充分性、腹膜转运特性、残余肾功能是影响腹膜透析患者营养状况的重要因素。Objective (1) To explore the relationship between insulin like growth factor 1 (IGF 1) and nutritional condition of patients with peritoneal dialysis (PD). (2) To study the influence of adequacy, transmitting feature of peritoneum, remnant renal function on nutritional condition and IGF 1 level of PD patients.Methods Body weight, height, BUN, Scr, albumin, complement, transferrin and IGF 1 were measured in 32 CAPD patients to evaluate their nutritional conditions; meanwhile, remnant renal function, ratio of creatinine concentrations of 24 hour dialysate to Scr (D/P), total creatinine clearance (Tcr) and urea clearance index (Kt/V) were determined. Results (1) There was a close correlation between IGF 1 and albumin, transferrin, complement. (2) IGF 1, albumin and transferrin increased significantly in Tcr≥60 L·wk -1 ·(1.73m 2) -1 group than that in Tcr < 60 L·wk -1 ·(1.73m 2) -1 group. Serum albumin level decreased significantly in D/P ≥0.81 group than that in 0.65≤D/P<0.81, D/P<0.65 groups. IGF 1 and albumin increased significantly in remnant renal function >2ml/min group than that in < 2ml/min group. Conclusion (1) IGF 1 is a sensitive early marker to evaluate nutritional condition in peritoneal dialysis. (2) Adequacy, transmitting feature of peritoneum and remnant renal function are important factors affecting on nutritional condition of PD patients.

关 键 词：腹膜透析 IGF-1 营养状况 

分 类 号：R459.5[医药卫生—治疗学]