持续性不卧床腹膜透析患者并发低蛋白血症30例临床分析

Clinical analysis of continuous ambulatory peritoneal dialysis complicated by serum hypoproteinemia in 30 patients

目的 研究腹膜透析患者并发低蛋白血症的发生情况,探讨其与C-反应蛋白（CRP）及其与各种炎性并发症的关系.方法 对2006年1月至2009年6月入院的60例持续性不卧床腹膜透析（CAPD）患者进行血清白蛋白（ALB）含量及其引发的相关并发症进行调查.根据ALB含量分为A组和B组,其中A组为营养良好,ALB含量正常;B组为合并低白蛋白血症患者.比较2组间CRP、转铁蛋白（TF）和主观营养评估法（SGA）的变化及其与临床并发症的关系.采用t检验及Pearson相关分析.结果 60例CAPD患者中,B组患者CRP含量[（8.40±1.32）mg/L]显著高于A组[（2.14±0.87）mg/L]（P＜0.01）;B组腹膜炎发生率为6.7%,肺炎发生率为13.3%,心血管疾病的发生率为16.7%,均明显高于A组（腹膜炎发生率为0,肺炎发生率为10%,心血管疾病的发生率为6.7%）（P均＜0.05）.结论 CAPD合并低白蛋白血症患者并发炎症及心血管疾病的发生率皆高于营养良好者.应重视腹膜透析患者营养不良-炎症-心血管疾病（动脉粥样硬化）综合征的诊治.

Objective To test the serum albumin level in patients having the peritoneal dialysis,and investigate its relationship with C-reactive protein（CRP）level or other inflammatory complications. Methods Sixty patients having peritoneal dialysis treatment were divided into two groups based on the serum albumin（ALB）level,patients had normal ALB level were included into group A,while the patients with serum hypoproteinemia were included into group B. The serum level of CRP,transferin（TF）and nutritional status were compared between two groups,and their relationship with clinical complications were evaluated. Results The serum CRP level in patients of group B（8.40 ± 1.32）mg/L was significantly higher than group A（2. 14 ±0.87）mg/L（P 〈0. 01）. Patients from group B had more inflammation complications,such as peritonitis（6. 7%）,pneumonia（13. 3%）,cardiovascular disease（16.7%）. Conclusions The continuous ambulatory peritoneal dialysis patients accompanied with hypoproteinemia are more likely to have inflammation complications and cardiovascular diseases,which should cause more attention on their malnutrition-inflammation- CVD（MIA）syndrome diagnosis and treatment.