摘要
【目的】初步探讨可能影响早期腹膜透析(PD)患者壁层腹膜间皮下致密层(SCZ)增厚的原因。【方法】通过对22例透析时间在6~48个月之间的非频繁腹膜炎发作的PD患者进行重复腹膜活检,比较患者透析前后SCZ变化情况,并分析其与透析时间、糖尿病、腹膜炎发作次数以及残余肾功等指标间的关系。【结果】22例患者平均透析时间为(20.1±9.5)个月,透析后SCZ平均厚度为(262±79)μm,显著高于透析前的(177±47)μm(P〈0.01)。糖尿病与非糖尿病患者透析后SCZ厚度较透析前分别增加66.4%和39.3%(P〉0.05),不同腹膜炎发作次数患者透析后SCZ厚度变化无显著差异(P〉0.05)。透析后患者SCZ厚度平均增加49.1%,其与患者的透析时间和透析前后残余肾功显著相关(P〈0.05),逐步回归分析显示患者透析时间以及透析后残余肾功能是主要的影响因素(P〈0.05)。【结论】在非频繁腹膜炎发作的早期PD患者,患者残余肾功能和透析时间是影响患者腹膜SCZ增厚的主要原因。
[Objective] To investigate the potential effect of various clinical parameters on the thickness of the sub-mesothelial compact zone(SCZ) in earlylstage peritoneal dialysis(PD) patients. [Methods] Parietal peritoneum biopsy and re-biopsy were taken in 26 peritoneal dialysis patients who had been dialyzed for more than 6 months and less than 48 months, and 4 patients were excluded because of frequent peritonitis. The first biopsy was taken during the procedure of catheter placement. And the re-biopsy was taken during the procedure of catheter removal or other abdominal surgery. The thickness of the SCZ and its changes were analyzed to find their relationship to the residual renal function (RRF), duration of PD, diabetes mellitus(DM) and peritonitis attack. [Results] Significant increment of the thickness of the SCZ was observed in re-biopsy species when compared with those at the beginning of dialysis (262 ± 79μm vs 177 ± 47μm, P 〈0. 01). An increased ratio of the thickness of the SCZ in patients with and without DM was 66.4% and 39.3%, respectively ( P 〈0.05). There were no significant differences in the changes of the thickness of SCZ among groups with different times of peritonitis attack( P〉0. 05). The changes of the thickness of SCZ were significantly correlated with RRP before and after dialysis and the duration of PD( P 〈0.05). The RRF after dialysis and the duration of PD were the main factors that affected the changes of the thickness of SCZ. [Conclusion] For those early peritoneal dialysis patients without frequent peritonitis attack, residue renal function and duration of PD are the main factors that can affect the thickening of SCZ.
出处
《医学临床研究》
CAS
2009年第7期1153-1155,共3页
Journal of Clinical Research
基金
南京市医学科技发展重点项目(ZKX0416)
关键词
腹膜透析
腹膜
peritoneal dialysis
peritoneum