腹膜通透性与腹透患者长期生存的关系

The correlation between the peritoneal transport characterization and the long-term survivalof peritoneal dialysis patients

目的 :探讨腹膜通透性类型与腹透长期存活的关系。方法 :测定 71例腹透病例透析初期 (3个月内 ) ,以及其中 18例持续腹透超过 4年的病例透析初期和远期 (4年以上 )的腹膜平衡试验 (PET) ,计算并分析各种腹膜通透类型长期生存概率 ,及长期存活病人腹膜通透性的变化情况。结果 :71例病人透析初期各种腹膜通透类型的比例分别为高转运 2 3 94%、高平均转运 39 44 %、低平均转运 2 6 76 %和低转运 9 86 %。 18例持续腹透超过 4年的病例中 ,高或高平均转运各 2例、低或低平均转运分别为 4例和 10例 ,生存概率分别为 11 76 %、7 14%、5 7 14%和 5 2 6 3%。其中 7例透析初期和远期腹膜通透性未发生变化 ,9例通透性较前降低 ,另 2例高血压肾病患者腹膜通透性则较前增高。结论 :各种腹膜通透类型均可能长期存活 ,但以低通透性腹膜长期生存概率较高 ,提示更适宜进行长期腹膜透析治疗。长期透析腹膜通透性可保持不变或不同程度降低 ,并观察到高血压肾病长期腹透后通透性较前增加的现象。

Objective:To investigate the correlation between the peritoneal transport characterization and the long-term survival of peritoneal dialysis patients Methods:Peritoneal equilibration test (PET)was performed in 71 peritoneal dialysis (PD)patients in the first three months of the dialysis ,and recently in 18 long-term PD patients (>4 years).The probability of long-term survival in different peritoneal transport types was analyzed,and the transformation of peritoneal transport types was observed.Results: In seventy-one PD patients,the percentage of different peritoneal transport characterization is as follows:high transporters 23 94%,high average transporters 39 44%,low average transport 26.76%and low transpotr 9.86%.In 18 long-term survival PD patients,2 patients with high transporters,2 with high average transporters,10 and 4 with low average transporters and low transports during the first three months of PD treatment.Their survival probabilities are 11.76%,7.14%,52.63% and 57.14% respectively.Also in these 18 patients,the peritoneal transport characterization maintains no change in 7 patients,and 9 patients showed transformation of peritoneal transport type had a lower transport than before,but 2 patients whose nephropathy were caused by essential hypertension had a higher peritoneal transport than before.Conclusion:The patients with each of four peritoneal transport type characterization might be long-term survival,but low or low average peritoneal transporters are better for long-standing peritoneal dialysis.In some of long-term PD treatment patients,the transformation of the peritoneal transport characterization may occurs,generally transporter declines.Interestingly,we found 2 nephrosclerosis patients with higher peritoneal transport transformations.