维持性腹膜透析患者容量负荷的危险因素及风险模型研究  

Study on risk factors and risk models of volume load in patients with maintenance peritoneal dialysis

作　　者：王静[1] 张灿[1] 秦琳琳 李婷婷[1] WANG Jing;ZHANG Can;QIN Lin-lin;LI Ting-ing(The First Department of Nephrology,the Fist Afflated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肾脏内一科,郑州450052

出　　处：《医药论坛杂志》2022年第13期1-4,共4页Journal of Medical Forum

基　　金：2021年河南省医学科技攻关计划项目(LHGJ202110197)。

摘　　要：目的探讨影响维持性腹膜透析患者容量负荷的相关危险因素,并建立相应风险模型。方法选择2021年1月至2021年12月郑州大学第一附属医院收治的腹膜透析患者60例为研究对象,回顾性分析患者一般资料,采用生物多频电阻抗术测定水负荷(OH)值,根据是否容量负荷分为病例组22例,对照组38例,并对其相关影响因素进行logistic回归分析,构建风险模型。结果60例腹膜透析患者中,发生容量负荷共22例(36.67%),其中,病例组合并糖尿病患者多于对照组(P<0.05),两组一般资料比较,差异不具有统计学意义(P>0.05);病例组患者的血清白蛋白、尿量显著低于容量对照组(P<0.05);而收缩压、人体总水分、细胞外液、细胞内液显著高于对照组(P<0.05);4h透析液肌酐/血肌酐比值(4h D/Pcr)、血尿素氮、血肌酐、血糖、血钠、舒张压、超滤量、透析液糖浓度等比较差异无统计学意义(P>0.05);以是否发生容量负荷作为结局变量,以表2中P<0.05的指标作为自变量;多因素分析结果提示合并糖尿病、低血清白蛋白及尿量、高收缩压是主要危险因素。结论合并糖尿病、高收缩压、低尿量及血清白蛋白是腹膜透析患者容量负荷的独立危险因素,临床进行持续腹膜透析时可根据以上指标进行早期识别。Objective To explore the risk factors of volume load in patients with maintenance peritoneal dialysis and establish a risk model.Methods Totally 60 patients with peritoneal dialysis admitted to our hospital from January 2021 to December 2021 were selected as the study subjects.The general data of the patients were retrospectively analyzed,and the water load(OH)value was measured by biological multifrequency electrical impedance.According to the capacity overload,the patients were divided into case group(n=22)and control group(n=38).The risk model was built by logistic regression analysis.Results There were 22 cases(36.67%)of the 60 patients with peritoneal dialysis with volume overload,and the number of patients with case combination and diabetes was more than that of the control group(P<0.05).There was no statistical significance between the two groups(P>0.05).Serum albumin and urine volume in case group were significantly lower than those in volume control group(P<0.05).Systolic blood pressure,total body moisture,extracellular fluid and intracellular fluid were significantly higher than those in control group(P<0.05).There were no significant differences in 4 h D/Pcr,blood urea nitrogen,blood creatinine,blood glucose,blood sodium,diastolic blood pressure,ultrafiltration and dialysate glucose concentration(P>0.05).The occurrence of capacity overload was taken as the outcome variable,and the index P<0.05 in Table 2 was taken as the independent variable.Multivariate analysis showed that diabetes mellitus,low serum albumin and urine volume and high systolic blood pressure were the main risk factors.Conclusion Diabetes mellitus,high systolic blood pressure,low urine volume and serum albumin are independent risk factors for volume load in patients with peritoneal dialysis,which can be used for early identification during clinical continuous peritoneal dialysis.

关 键 词：腹膜透析 容量负荷 危险因素 风险模型 

分 类 号：R459.5[医药卫生—治疗学]