腹膜透析对尿毒症患者肺功能的影响

The Influence of Peritoneal Dialysis on the Pulmonary Function of Patients with End-stage Renal Disease.

目的 了解尿毒症患者腹膜透析治疗前后的肺功能变化。方法 分别测定 5 0例尿毒症患者及2 0例正常人的用力肺活量 (FVC)、最大通气量 (MBC)、1秒钟用力呼气容积 (FEV1 )、最大呼气流量 (PEF)、最大呼气中段流量 (MMEF)、2 5 %肺活量最大呼气流量 (·V2 5)和肺一氧化碳弥散量 (DL co)等参数 ,其中 30例尿毒症患者在透析治疗 2月后进行了上述参数的复查。结果 尿毒症患者的肺通气量和气道功能指标 FVC、MBC、FEV1 、PEF、MMEF、·V2 5以及肺弥散功能指标 DL co均明显低于正常人 ;透析治疗后 ,尿毒症患者的气道功能指标 FEV1 、PEF、MMEF和 ·V2 5明显改善 (P<0 .0 5 ) ,但肺通气量指标 FVC、 MBC和肺弥散功能指标 DL co无明显改善 (P>0 .0 5 )。结论 尿毒症患者存在肺通气功能及弥散功能的降低 ,伴气道阻塞 ;透析治疗能显著改善气道阻塞 ,但对肺弥散功能及肺通气量无明显改善 。

Objective To demonstrate the change of pulmonary function in patients with end stage renal disease(ESRD) before and after peritoneal dialysis (PD). Methods In this study were measured the forced vital capacity(FVC),maximum breathing capacity(MBC), the forced expiratory volume of the first second(FEV 1),maximal expiratory flow(MEF), maximal mid expiratory flow rate(MMEF),25% of maximal expiratory flow (·V 25 ), and the diffusion of co in lung (DLco) for 50 patients with end stage renal disease and 20 normal subjects. All the indexes were determined again in 30 ESRD patients two months after peritoneal dialysis. Results The indexes of pulmonary ventilation (FVC,MBC,FEV 1,PEF,MMEF,·V 25 ) and the pulmonary diffusion DLco were lower in the ESRD patients than in the controls.FEV 1,PEF,MMEF and ·V 25 were improved markly after peritoneal dialysis in ESRD patients ( P< 0.05); FVC, MBC,and DLco were of no change ( P >0.05).Conclusion The function of pulmonary ventilation and diffusion are decreased in patients with ESRD accompanied with airways obstruction. Peritoneal dialysis can improve airways obstruction remarkably, but it has no effect on the function of pulmonary ventilation and diffusion.