持续非卧床腹膜透析患者低蛋白血症的影响因素分析

Analysis of influencing factors for hypoproteinemia in patients undergoing continuous ambulatory peritoneal dialysis

目的:分析持续非卧床腹膜透析(CAPD)患者低蛋白血症的影响因素。方法:回顾性分析2018年1月—2022年12月玉林市第一人民医院收治的CAPD患者,按血清白蛋白水平分为低蛋白组(n=132)和正常蛋白组(n=215),比较两组临床资料,使用Logistic回归分析模型分析低蛋白血症的危险因素。结果:低蛋白组的血清白蛋白、左室射血分数、白细胞、血红蛋白、球蛋白、前白蛋白、总胆固醇、甘油三酯和血钙水平低于正常蛋白组,24 h腹透液蛋白浓度、24 h腹透液蛋白总量高于正常蛋白组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,左室射血分数、血红蛋白、前白蛋白和甘油三酯下降是CAPD患者低蛋白血症的影响因素(P<0.05)。结论:CAPD患者低蛋白血症发生率较高。左室射血分数、血红蛋白、前白蛋白和甘油三酯下降是CAPD患者低蛋白血症的影响因素。积极预防和治疗心力衰竭与心肌重构,纠正贫血,进行营养评估和干预,以预防低蛋白血症的发生。

Objective To analyze the influencing factors of hypoproteinemia in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods A retrospective analysis was conducted on CAPD patients treated at The First People's Hospital of Yulin City from January 2018 to December 2022.Patients were divided into a hypoproteinemia group(n=132)and a normal protein group(n=215)based on serum albumin levels.Clinical data between the two groups were compared,and a logistic regression analysis model was used to identify the influencing factors for hypoproteinemia.Results The levels of serum albumin,left ventricular ejection fraction,white blood cells,hemoglobin,globulin,prealbumin,total cholesterol,triglyceride and blood calcium in the low protein group were lower than those in the normal protein group,and the 24-hour peritoneal effluent protein concentration and total 24-hour peritoneal effluent protein were higher than those in the normal protein group,with statistical significance(P<0.05).Logistic regression analysis revealed that left ventricular ejection fraction,hemoglobin,prealbumin and triglycerides were influencing factors for hypoproteinemia in CAPD patients(P<0.05).Conclusions The incidence of hypoproteinemia was relatively high in CAPD patients.Decreased left ventricular ejection fraction,hemoglobin,prealbumin,and triglyceride levels were significant influencing factors for hypoproteinemia in these patients.Actively preventing and treating heart failure and myocardial remodeling,correcting anemia,and conducting nutritional assessments and interventions were essential to prevent the onset of hypoproteinemia.