氨基酸腹膜透析对腹膜透析患者生化指标、透析效能及营养状况的影响  

Effects of amino acid peritoneal dialysis on biochemical index,dialysis efficiency and nutritional status of peritoneal dialysis patients

作　　者：刘红 程铭 姜琳 管文琦 曹船沁 苏雪梅 LIU Hong;CHENG Ming;JIANG Lin(Department of Kidney Medicine,Yangpu Hospital Affiliated to Tongji University,Shanghai 200090,China)

机构地区：[1]同济大学附属杨浦医院肾脏内科,上海200090

出　　处：《临床和实验医学杂志》2020年第13期1387-1390,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市科学技术委员会创新行动计划支持项目(编号:19ZR1447300)。

摘　　要：目的探讨氨基酸腹膜透析对腹膜透析患者透析效能和营养状况的影响。方法采用回顾性研究方法,选取2017年8月至2019年8月同济大学附属杨浦医院收治的腹膜透析患者40例,依据不同的腹膜透析液分为氨基酸腹膜透析组和葡萄糖腹膜透析组,每组各20例。葡萄糖腹膜透析组患者应用1.5%葡萄糖腹膜透析液进行透析,氨基酸腹膜透析组患者接受0.491%氨基酸腹膜透析液进行透析,比较两组患者的总胆固醇(Ch)、转铁蛋白(Tri)、高密度脂蛋白(HDL)、二氧化碳结合力(CO2-cp)等一般生化指标、血肌酐(Ccr),透析液尿素-肌酐(R-Ccr)、腹膜-残余肾总尿素(Kt/v)等透析效能指标和前白蛋白(Alb)、转铁蛋白(TF)、前白蛋白(PA)等营养状况指标。结果氨基酸腹膜透析组患者治疗前后的Ch、Tri、HDL、CO2-cp水平比较,差异均无统计学意义(P>0.05)。葡萄糖腹膜透析组患者治疗后的Ch、Tri水平高于治疗前(P<0.05);但治疗前后的HDL、CO2-cp水平比较,无显著差异(P>0.05)。相较于葡萄糖腹膜透析组,在治疗后氨基酸腹膜透析组患者Ch、Tri水平均明显较低(P<0.05)。氨基酸腹膜透析组患者治疗后较治疗前的Ccr、R-Ccr、Kt/v降低幅度均显著高于葡萄糖腹膜透析组(P<0.05)。氨基酸腹膜透析组患者治疗前Alb、TF、PA分别为(38.7±6.8)g/L、(2.53±0.36)g/L、(461.4±70.3)g/L,治疗后Alb、TF、PA分别为(41.5±3.8)g/L、(2.86±0.13)g/L、(479.6±75.2)g/L;葡萄糖腹膜透析组患者治疗前Alb、TF、PA分别为(37.7±4.6)g/L、(2.50±0.46)g/L、(460.1±76.3)g/L,治疗后Alb、TF、PA分别为(38.6±5.7)g/L、(2.40±0.52)g/L、(351.6±52.4)g/L。氨基酸腹膜透析组患者治疗后的Alb、TF、PA水平均显著高于治疗前,葡萄糖腹膜透析组治疗后的TF、PA水平显著低于治疗前(P<0.05)。治疗后,氨基酸腹膜透析组患者的Alb、TF、PA水平均显著高于葡萄糖腹膜透析组(P<0.05)。结论氨基酸腹膜透析能够有效改善腹�Objective To explore the effects of amino acid peritoneal dialysis on dialysis efficacy and nutritional status of peritoneal dialysis patients.Methods 40 cases of patients with peritoneal dialysis in Yangpu Hospital Affiliated to Tongji University from August 2017 to August2019 were retrospectively selected and divided into amino acid peritoneal dialysis group(AAPD group)and glucose peritoneal dialysis group(GPD group)according to different peritoneal dialysate,20 cases in each group.In the GPD group,1.5%glucose peritoneal dialysate was used for dialysis,while in the AAPD group,0.491%amino acid peritoneal dialysate was used for dialysis.The General biochemical indexes such as total cholesterol(CH),transferrin(TRI),high density lipoprotein(HDL),carbon dioxide binding force(CO2 CP),dialysis efficiency indexes such as blood creatinine(CCR),dialysate urea creatinine(r-ccr),peritoneum residual kidney total urea(kt/V),prealbumin(ALB),transferrin(TF),prealbumin(PA)nutritional status indexes of the two groups were statistically analyzed.Results There was no significant difference in total cholesterol(CH),transferrin(TRI),high density lipoprotein(HDL)and carbon dioxide binding capacity(CO2 CP)before and after treatment in AAPD group(P>0.05).After treatment,the levels of Ch and Tri were significantly higher than those before treatment(P<0.05),but there was no significant difference in the levels of HDL and CO2-cp before and after treatment(P>0.05).After treatment,the levels of CH and tri in AAPD group were significantly lower than those in GPD group(P<0.05).The decrease of serum creatinine(CCR),dialysate urea creatinine(r-ccr),peritoneal residual kidney total urea(kt/V)in AAPD group was significantly higher than that in GPD group(P<0.05).ALB,TF and PA were(38.7±6.8)g/L,(2.53±0.36)g/L,(461.4±70.3)g/L in AAPD group,and(41.5±3.8)g/L,(2.86±0.13)g/L,(479.6±75.2)g/L in GPD group after treatment,ALB,TF and PA were(38.6±5.7)g/L,(2.40±0.52)g/L,(351.6±52.4)g/L,respectively.The levels of ALB,TF and PA in the AAPD group were

关 键 词：氨基酸腹膜透析 生化指标 透析效能 营养状况 

分 类 号：R692.5[医药卫生—泌尿科学]