腹膜透析患者容量状态与MIA综合征各组分之间的关系  

Relationship Between Volume Status and Malnutrition-Inflammation-Atherosclerosis in Peritoneal Dialysis Patients

作　　者：田祥银[1] 汪涛[2] 徐家云[1] 

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

出　　处：《河南科技大学学报（医学版）》2012年第1期31-34,共4页Journal of Henan University of Science & Technology:Medical Science

摘　　要：目的探讨腹膜透析患者容量状态与营养、炎症、动脉硬化之间的关系。方法选取稳定的持续不卧床腹膜透析患者(CAPD)139人,利用人体成分分析仪(BCM)测量患者的细胞外液(ECW)、细胞内液(ICW)、OH值,对患者的容量状态进行评估,脉压(PP)作为患者动脉硬化的诊断指标,白蛋白和肌酐作为营养的评价标准,C-反应蛋白(CRP)作为炎症指标,分析容量和营养、炎症、动脉硬化之间的相关性及各自的独立影响因素。结果 BCM测量的体成分指标与容量指标TBW、ECWI、CW、OH与白蛋白成负相关;TBW、ECWI、CW与肌酐成正相关;TBW、ECWI、CW、OH与CRP成正相关;OH与PP成正相关(均P<0.05),年龄(P<0.05)、ECW(P<0.001)是血浆白蛋白的独立影响因素;ECW(P=0.000)是C-反应蛋白的独立影响因素;年龄(P=0.000)、BMI(P<0.05)、收缩压(P=0.000)是脉压的独立影响因素,年龄(P<0.05)、SBP(P=0.000)、Alb(P<0.05)、PP(P<0.05)、CRP(P<0.01)、ECW(P=0.000)I、CW(P=0.000)均是OH的独立危险因素。结论 BCM的容量参数与营养障碍、炎症、动脉硬化之间有很好的相关性。Objective To investigate the relationship between volume status measured by body composition monitor（BCM） and nutrition,inflammation,atherosclerosis in PD patients. Methods From June to August,2009.139 peritoneal dialysis patients was enrolled.Volume status was determined by measuring extracellular water（ECW）,total body water（TBW）,intracellular water（ICW）,overhydration value（OH） by BCM.Measurement of pulse pressure was used to assess the presence of subclinical atherosclerosis.Serum albumin and creatinine was used as a nutritional marker,and serum C-reactive protein（CRP） was used as an inflammatory marker.To explore the relationship between volumes status measured by body composition monitor（BCM） and nutrition,inflammation,atherosclerosis and independent factors,respective. Results TBW,ECW,ICW,OH were negative with albumin,TBW,ECW,ICW were positive with serum creatinine;TBW,ECW,ICW,OH were positive with CRP;OH were positive with PP,these results were significant（P0.05）;age（P0.05）,ECW（P0.001） was the independent risk factors of plasma albumin;For C-reaction,the independent risk factors was ECW（P=0.000）;Age（P=0.000）,BMI（P0.05）,systolic blood pressure（P=0.000） was the independent risk factors of PP;Age（P0.05）,SBP（P=0.000）,Alb（P0.05）,PP（P0.05）,CRP（P0.01）,ECW（P=0.000）,ICW（P=0.000） were independently associated with OH. Conclusion Volume parameters of BCM are correlated well with markers of nutrition,inflammation and atherosclerosis.

关 键 词：腹膜透析 容量状态 营养障碍 炎症 动脉硬化 

分 类 号：R459.5[医药卫生—治疗学]