不同透析方式对慢性肾脏病5期患者血管钙化和心脏结构变化及肾功能影响  

Comparison of effects of different dialysis methods on vascular calcification, cardiac structural changes and residual renal function in patients with stage 5 chronic kidney disease

作　　者：赵晶珂 贾明璐[2] 马靖宜 刘芳怡[4] ZHAO Jingke;JIA Minglu;MA Jingyi;LIU Fangyi(Luohe Central Hospital,Luohe First People's Hospital,Luohe 462000,China;Department of Internal Medicine Diagnosis,Luohe Medical Advanced Vocational School,Luohe 462000,China)

机构地区：[1]漯河市中心医院血液净化室,漯河市第一人民医院,河南漯河462000 [2]漯河市中心医院药剂科,漯河市第一人民医院,河南漯河462000 [3]漯河市中心医院肾内科,漯河市第一人民医院,河南漯河462000 [4]漯河医学高等专科学校内科诊断教研室,河南漯河462000

出　　处：《社区医学杂志》2023年第6期299-303,共5页Journal Of Community Medicine

摘　　要：目的 探讨维持性血液透析与腹膜透析对慢性肾脏病(CKD)5期患者心肾功能及血管钙化的影响。方法 选取2017-08-07-2022-03-12漯河市中心医院收治的100例CKD 5期患者作为研究对象,根据透析方式不同分为维持性血液透析组和腹膜透析组,各50例。对比2组患者血管钙化情况、心脏结构变化及残余肾功能。结果 腹膜透析组主动脉弓钙化总发生率为24.00%(12/50)、颈动脉钙化总发生率为28.00%(14/50),均低于维持性血液透析组的44.00%(22/50)、48.00%(24/50),差异有统计学意义,χ^(2)值分别为4.456、4.245,P值分别为0.035、0.039;2组间钙化程度比较差异无统计学意义,P>0.05。治疗5个月后,腹膜透析组左心室舒张末期内径(LVEDD)为(43.97±1.91) mm,低于维持性血液透析组的(46.86±1.53) mm,F=596.274,P<0.001;左房内径(LAD)为(36.78±5.16) mm,低于维持性血液透析组的(37.64±5.11) mm,F=25.773,P<0.001;左室厚壁舒张期厚度(LVPWDT)为(11.13±1.21) mm,低于维持性血液透析组的(12.07±1.38) mm,F=120.693,P<0.001。治疗5个月后,腹膜透析组尿素氮(BUN)水平为(12.91±2.04) mmol/L,低于维持性血液透析组的(17.64±2.13) mmol/L,F=2 939.745,P<0.001;血肌酐(Scr)水平为(463.71±80.23)μmol/L,低于维持性血液透析组的(597.21±107.46)μmol/L,F=2 042.685,P<0.001;肾小球滤过率(eGFR)水平为(5.86±2.24) mL/(min·1.73 m2),高于维持性血液透析组的(4.62±2.07) mL/(min·1.73 m2),F=44.394,P<0.001。结论 腹膜透析可更好的改善CKD 5期患者残余肾功能,降低血管钙化发生,改善其心脏结构。Objective To investigate the effects of maintenance hemodialysis and peritoneal dialysis on cardiac and kidney function and vascular calcification in patients with stage 5 chronic kidney disease(CKD).Methods A total of 100 patients with stage 5 CKD in Luohe Central Hospital from August 7,2017 to March 12,2022 were selected as the research objects.According to different dialysis methods,they were divided into maintenance hemodialysis and peritoneal dialysis groups,with 50 cases in each group.Vascular calcification,cardiac structural changes and residual renal function were compared between the two groups.Results The total incidence of aortic arch calcification and carotid artery calcification in peritoneal dialysis group was 24.00%(12/50) and 28.00%(14/50) respectively,lower than that in maintenance hemodialysis group,which was 44.00%(22/50) and 48.00%(24/50),respectively,and the difference was statistically significant(χ^(2)=4.456 and 4.245,P-0.035 and 0.039).There was no difference in calcification degree between the two groups(P>0.05).The left ventricular end-diastolic dimension(LVEDD) level in the peritoneal dialysis group was(43.97±1.91)mm,lower than that in the maintenance hemodialysis group(46.86 ± 1.53) mm,F=596.274,P<0.001;The left atrial diameter(LAD) level was(36.78±5.16) mm lower than that in maintenance hemodialysis group(37.64±5.11) mm,F=25.773,P<0.001;The diastolic thickness of left ventricular thick wall(LVPWDT) was(11.13 ± 1.21) mm and(12.07±1.38) mm in the maintenance hemodialysis group,F=120.693,P<0.001.The blood urea nitrogen(BUN) level at the end of 5 months in the peritoneal dialysis group was(12.91±2.04) mmol/L,lower than that in the maintenance hemodialysis group(17.64±2.13) mmol/L,F=2 939.745,P<0.001;Serum creatinine(Scr) level was(463.71±80.23) μmol/L lower than that in maintenance hemodialysis group(597.21 ± 107.46) μmol/L,F=2 042.685,P<0.001;The glomerular filtration rate(eGFR) level was(5.86±2.24) mL/(min·1.73 m~2) higher than that in the maintenance hemodialysis group(4

关 键 词：慢性肾脏病 血管钙化 残余肾功能 维持性血液透析 腹膜透析 

分 类 号：R692[医药卫生—泌尿科学]