持续非卧床腹膜透析患者腹膜转运特性与微炎症状态的相关性分析  

Correlation Between Peritoneal Transport Characteristics and Microinflammation Status in Patients with Continuous Ambulatory Peritoneal Dialysis

作　　者：张继超 李媛媛 厉娟 孙响波 ZHANG Jichao;LI Yuanyuan;LI Juan(Department of Nephrology and Immunology,Rizhao Central Hospital,Shandong Province,Rizhao(276800))

机构地区：[1]山东省日照市中心医院肾病免疫科,日照276800 [2]山东省日照市中心医院门诊综合服务中心,日照276800 [3]山东省青岛市中医医院肾病科,青岛266000

出　　处：《中国中西医结合肾病杂志》2020年第9期780-783,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：山东中医药科技发展计划项目(No.2017-333);青岛市医疗卫生优秀人才培养项目。

摘　　要：目的:探讨持续非卧床腹膜透析(CAPD)患者腹膜转运类型与微炎症状态的相关性。方法:将60例行CAPD治疗的患者行腹膜平衡试验(PET),根据患者腹膜转运的特性,分高转运组、低转运组各30例。对照组为健康查体者30例。各组常规实验室方法检测患者肾功能BUN、Scr、β2-MG与TC、TG、HDL、LDL水平及微炎症标志物hs-CRP、Alb、PCT水平。记录24 h尿量,检测24 h尿蛋白定量水平,评估eGFR及RRF。结果:与对照组比较,高转运组、低转运组患者hs-CRP、PCT、TC、TG、LDL水平显著升高(P<0.01),Alb、HDL水平显著降低(P<0.01);与高转运组比较,低转运组患者hs-CRP、PCT、TC、TG、LDL水平明显升高(P<0.05),Alb、HDL水平明显降低(P<0.05)。结论:低转运组患者伴发脂质代谢紊乱、微炎症状态程度明显高于高转运组,提示低转运组患者对毒素清除、脂质代谢、炎症反应的调控力差,对CAPD患者残余肾功能保护作用弱。Objective:To investigate the relationship between peritoneal transport type and microinflammation status in patients with continuous ambulatory peritoneal dialysis(CAPD).Methods:Sixty patients who underwent CAPD were treated with peritoneal balance test(PET).According to the characteristics of peritoneal transport,30 patients were divided into high transport group and low transport group.The control group was 30 healthy subjects.The routine laboratory methods of each group were used to detect the levels of renal function BUN,Scr,β2-MG and TC,TG,HDL,LDL and microinflammation markers hs-CRP,Alb,PCT.24 h urine volume was recorded,24-hour urine protein level was measured,and e GFR and RRF were evaluated.Results:Compared with the control group,the levels of hs-CRP,PCT,TC,TG and LDL were significantly increased in the high transport group and low transport group(P<0.01),and the levels of Alb and HDL were significantly decreased(P<0.01).Compared with the group,the levels of hs-CRP,PCT,TC,TG and LDL in the low-transport group were significantly increased(P<0.05),and the levels of Alb and HDL were significantly decreased(P<0.05).Conclusion:The low-transport group is associated with lipid metabolism disorder and micro-inflammation status,which is significantly higher than that of the high-transport group.It suggests that patients in the low-transport group have poor regulation of toxin clearance,lipid metabolism and inflammatory response,and have residual renal function protection in patients with CAPD.The effect is weak.

关 键 词：CAPD 腹膜转运特性 微炎症状态 

分 类 号：R692.5[医药卫生—泌尿科学]