基线腹膜转运特性对CAPD患者腹膜蛋白丢失、生存率及腹膜炎发生率的影响  

Effects of Baseline Peritoneal Membrane Transport Characteristics on Peritoneal Protein Clearance,Survival and the Incidence of Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients

作　　者：陈香慧 张晶晶[1] 陈钊[1] 马芳霞 杨静[1] 魏琳婷 田李芳[1] 王皓东 王莉[1] 付荣国[1] CHEN Xianghui;ZHANG Jingjing;CHEN Zhao(Department of Nephrology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an,710004)

机构地区：[1]西安交通大学第二附属医院肾病内科,西安710004

出　　处：《中国中西医结合肾病杂志》2024年第3期215-218,263,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金资助项目(No.82000699)。

摘　　要：目的:观察基线腹膜转运特性对持续不卧床腹膜透析(CAPD)患者腹膜蛋白丢失、腹膜炎发生率及生存率的影响。方法:回顾性分析2014年01月—2021年01月在我院行腹膜透析手术并规律CAPD治疗≥1年的91例患者作为研究对象,根据术后首次的腹膜平衡试验(PET)结果,将患者分为4组:高转运组(H)、高平均转运组(HA)、低平均转运组(LA)及低转运组(L),比较各组腹膜蛋白清除率(PrC)及腹膜炎发生率,分析终末期肾脏病(ESRD)不同原发病与其基线腹膜转运特性之间的关系。Kaplan-Meier生存曲线比较HT组(H和HA)和LT组(LA和L)患者的生存情况。结果:PrC水平在H、HA、LA及L四组间存在显著差异,H组的PrC水平显著高于HA、LA及L组,而其血清白蛋白水平显著低于其余三组(P<0.05)。不同ESRD原发病的患者,其基线腹膜转运特性也存在差异,糖尿病肾病患者的基线腹膜转运特性多为HA及H,而慢性肾小球肾炎患者的基线腹膜转运特性多为LA及HA。腹膜炎发生率及生存率在HT组和LT组差异无统计学意义(P>0.05)。结论:ESRD原发病不同可影响其基线腹膜转运特性的分布,不同基线腹膜转运特性PD患者间PrC水平存在显著差异,腹膜高转运特性的患者多伴有高的PrC水平和低的血白蛋白水平,而腹膜转运特性对CAPD患者的腹膜炎发生率及生存率无显著影响。Objective:To investigate the effect of baseline peritoneal transport characteristics on peritoneal protein loss,incidence of peritonitis and outcomes in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods:91 patients who received regular CAPD for more than one year in our hospital from January 2014 to January 2021 were retrospectively analyzed.According to the results of the first peritoneal equilibration test(PET),patients were divided into four groups:high transport group(H),high average transport group(HA),low average transport group(LA)and low transport group(L).The peritoneal protein clearance(PrC)among the four groups were compared.The relationship between different primary diseases of ESRD and baseline peritoneal transport characteristics were also analyzed.Kaplan-Meier survival curves were used to analyze the survival of patients in the HT group(H and HA)and LT group(LA and L).Results:There were significant differences in PrC levels among these four groups.The level of PrC in the H group was significantly higher than that in HA group,LA group and L group,(P<0.05),while the level of serum albumin was significantly lower than that in other three groups.Baseline peritoneal transport characteristics were mostly HA and H in patients with diabetic nephropathy,while the LA and HA were the primary transport characteristics in patients with chronic glomerulonephritis.The in HT group was higher than that in LT group,There were no significant differences in the incidence of peritonitis and survival rate between HT group and LT group(P>0.05).Conclusion:Different primary diseases of ESRD effects the baseline peritoneal transport characteristics of CAPD patients.Patients with high peritoneal transport are often accompanied by high PrC levels and low serum albumin levels,while peritoneal transport characteristics have no significant impact on the incidence of peritonitis as well as survival rate of CAPD patients.

关 键 词：腹膜平衡试验 腹膜转运特性 持续不卧床腹膜透析 腹膜蛋白清除率 

分 类 号：R692.5[医药卫生—泌尿科学]