腹膜透析患者容量超负荷影响因素研究  

Study on the influencing factors of volume overload in patients with peritoneal dialysis

作　　者：付丽娜[1] 陈娜[1] 马亚琪 田娜[1] 陈孟华[1] FU Lina;CHEN Na;MA Yaqi;TIAN Na;CHEN Menghua(Department of Nephrology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院肾脏内科,宁夏银川750004

出　　处：《宁夏医学杂志》2022年第7期590-593,共4页Ningxia Medical Journal

基　　金：宁夏医科大学校级科研资助项目(XM2018149)。

摘　　要：目的 通过人体多频生物电阻抗评估技术(BIA)采集数据,分析腹膜透析患者容量超负荷的影响因素,预测各项指标中容量超负荷的危险因素。方法 选择腹膜透析患者93例,将患者根据容量超负荷(OH)指数分为3组,OH≤-1.1L为低容量组(22例),-1.1~L为等容量组(22例),OH≥1.1 L为高容量组(49例)。采用BIA对腹膜透析患者的基本指标进行测定并进行统计分析。结果 3组间男女性别构成及原发病比较有统计学意义(P <0.05),其中高容量组男性占比居多,原发病主要为2型糖尿病。三组血钙、甲状旁腺激素(i PTH)、总胆固醇、白蛋白、TBW、ECW、ICW、E/T水平比较差异均有统计学意义(P <0.05)。对腹膜透析患者进行容量超负荷危险因素的logistic回归分析发现,原发性疾病为2型糖尿病、ECW、E/T是容量超负荷患者的危险性因素,女性、i PTH、TBW、ICW、白蛋白是容量超负荷患者的保护性因素。结论 在临床上利用BIA法可以准确评估腹膜透析患者的容量状况,其中2型糖尿病、ECW、E/T是容量超负荷患者的危险性因素,女性、i PTH、TBW、ICW、白蛋白是容量超负荷患者的保护性因素。Objective To collect the data by using multi-frequency bioelectrical impedance assessment(BIA)system,and to analyze the influencing factors of volume overload in patients with peritoneal dialysis(PD)and to predict the risk factors of volume overload in various indexes.Methods 93 PD patients were divided into three groups according to volume overload(OH)index,OH≤-1.1~L was low volume group(22 cases),-1.1~L was equal volume group(n=22),OH≥1.1 L was high volume group(n=49).The basic indicators of PD patients were measured and collected effective data by using BIA.Results There were statistically significant differences in gender composition and primary morbidity among the three groups(P<0.05),and in the high volume was accounted for the majority in males,and the primary disease was mainly in patients with type 2 diabetes(T2DM).There was statistical significance in serum calcium,parathyroid hormone(iPTH),total cholesterol,albumin,TBW,ECW,ICW and E/T levels among the three groups(P<0.05).The risk factors for volume overload in patients with peritoneal dialysis showed that the primary disease was T2DM,ECW and E/T were the risk factors for volume overload,female,iPTH,TBW,ICW and albumin were protective factors in patients with volume overload.Conclusion BIA could accurately evaluate the volume status of patients with peritoneal dialysis,and type 2 diabetes mellitus,ECW and E/T are risk factors for patients with volume overload,while female,iPTH,TBW,ICW and albumin are protective factors for patients with volume overload.

关 键 词：腹膜透析 容量超负荷 营养不良 

分 类 号：R459.5[医药卫生—治疗学]