腹膜透析患者腹膜转运类型与营养状况的相关性研究

Relationship of peritoneal transport patterns and the nutritional status in continuous ambulatory peritoneal dialysis patients

目的探讨持续性非卧床腹膜透析(CAPD)患者腹膜转运类型对其营养状况的影响。方法选择2010年1月至2012年12月在该院腹膜透析中心行CAPD的89例患者,根据腹膜平衡试验腹膜透析液与血中肌酐比值(D/Pcr)将患者分为LA组(低平均转运)和HA组(高平均转运),比较2组患者的营养状况,包括血清清蛋白(ALB)、前清蛋白(PA)、血清转铁蛋白(TF)、血红蛋白(Hb)、主观综合性营养评分(SCA)、瘦体质量(LBM)和标准化总氮出现率相当蛋白(nPNA),并对D/Pcr与营养指标进行相关性分析。结果 HA组D/Pcr显著高于LA组(P<0.01);HA组患者ALB、PA、TF、Hb和SGA均显著低于LA组患者(P<0.01),但两组患者的nPNA差异无统计学意义(P>0.05);CAPD患者D/Pcr与ALB、TF、Hb和SGA呈显著负相关(P<0.01),但是与PA、LBM和nPNA不相关(P>0.05)。结论腹膜透析患者营养状态与腹膜转运类型相关,高平均转运腹膜透析患者营养状态较低平均转运者差,故应加强对该类患者的营养指导。

Objective To explore the relationship of peritoneal transport patterns and the nutritional status in continuous ambulatory peritoneal dialysis（CAPD）patients.Methods 89patients who took CAPD in 2010January to December 2012in the peritoneal dialysis center of our hospital were selected in this study.According to the ratio of creatinine in peritoneal dialysis solution and in blood（D/Pcr）of the peritoneal equilibrium test（PET）,all CAPD patients were divided into HA group（high average transport） and LA group（low average transport）.Nutritional status including serum albumin（ALB）,prealbumin（PA）,transferrin（TF）,hemoglobin（Hb）,Lean body mass（LBM）,subjective global assessment（SGA）and normalized Protein Equivalent of Nitrogen Appearance（nPNA）were compared in both groups.The relationship of D/Pcr and the nutritional status were analyzed.Results D/Pcr in HA group were significantly higher than in LA group（P0.01）.ALB,PA,TF,Hb and SGA in HA group were significantly higher than in LA group（P0.01）,but nPNA in two groups has no statistical differences（P0.05）.D/Pcr was negative related to ALB, TF,Hb and SGA（P0.01）,but not related to nPNA,PA and LBM（P0.05）.Conclusion The nutritional status is related to peritoneal transport patterns in peritoneal HA patients,it is necessary to strengthen nutritional guidance,as the nutritional status is worse compared to LA ones.