肝脏疾病对腹膜透析患者血氨水平的影响  

The effect of suffered from liver diseases on venous ammonia in continuous ambulatory peritoneal dialysis patients

作　　者：高翔[1,2] 田信奎[1] 徐家云[2] 汪涛[1] 

机构地区：[1]北京大学第三医院肾内科,北京100191 [2]河南科技大学第一附属医院肾内科,河南洛阳471003

出　　处：《河南医学研究》2011年第2期161-164,共4页Henan Medical Research

摘　　要：目的:探讨同时伴有肝脏疾病的持续性非卧床腹膜透析(CAPD)患者对体内血氨水平的影响。方法:对2010年3月在北京大学附属第三医院肾内科接受CAPD患者进行横断面调查。采用全自动干式生化分析仪测定静脉血氨;同时收集相关的生化指标。采用均数比较及多因素分析等统计学方法探讨CAPD患者肝脏疾病与血氨升高之间的关系。结果:共144例符合条件的患者入选本研究。根据总体有无肝脏疾病将患者分为两组,结果为男性患肝脏疾病者明显多于女性(P<0.05),前者血白蛋白(ALb)和平方根残肾K t/V(P<0.05)均明显小于后者,而前者血氨(P<0.01)明显大于后者。多元线性回归分析提示,高的PNA、血白蛋白减少、低的平方根残肾K t/V及有肝脏疾病是静脉血氨升高的独立影响因素(R2=0.339,P<0.05)。结论:本研究表明在肾脏功能衰竭的CAPD的患者中,当同时患有肝脏疾病时,更容易造成患者血氨升高。Objective： To study the effect of suffered from liver diseases on venous ammonia 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 March 2010.We collected data including venous ammonia,OH,residual renal function,dialysis adequacy and other biochemical indicators.Comparisons between groups and multivariate analysis were used to explore the relationship between the liver diseases and venous ammonia.Results： 144 patients were included in the present study.Patients were divided into two groups according to with or without liver disease.Venous ammonia,gender,ALb,and residual renal function were significantly different in the two groups.Multivariate analysis further showed that PNA,ALb,residual renal function,and had liver diseases were independent risk factors affecting the level of venous ammonia after adjusting for gender,age,OH,BUN,dialysis adequacy,lgCRP and urine volume（R^2=0.339,P0.05）.Conclusion： This study showed that liver diseases effected upon the elevated blood ammonia in CAPD patients.

关 键 词：血氨 肝脏疾病 残余肾功能 持续性非卧床腹膜透析 

分 类 号：R459.5[医药卫生—治疗学]