腹膜透析患者容量变化对内皮功能的影响

Influence of volume on endothelial function in peritoneal dialysis patients

目的探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者容量变化对内皮功能的影响。方法 CAPD患者93例,随访6个月,应用多频生物电阻抗分析仪检测容量状态,根据随访前、后容量变化分为容量下降组30例、容量未变化组42例和容量增加组21例,采用彩色多普勒超声仪检测血流介导的扩张反应(flowmediated dilatation,FMD),比较3组随访前、后FMD水平。结果随访6个月时,容量下降组FMD(8.36±5.20)%较随访前((6.05±3.76)%)明显增加(P<0.05),容量增加组FMD((6.50±3.27)%)较随访前明显下降((9.94±4.99)%)(P<0.01),容量未变化组FMD((6.81±3.80)%)与随访前((6.80±5.35)%)比较差异无统计学意义(P>0.05),且容量下降组FMD明显高于容量未变化组和容量增加组(P<0.05)。结论 CAPD患者容量与FMD纵向变化密切相关,容量对内皮功能有重要影响。

Objective To explore the influence of volume changes on endothelial function in continuous ambulatory peritoneal dialysis （CAPD） patients. Methods Ninety-three CAPD patients were followed up for 6 months and evaluated the volume by multiple frequency bioelectrical impedance analysis. According to the volume changes before and after follow-up survey, the patients were divided into decreased volume group （n= 30）, stable volume group （n= 42） and increased volume group （n=21）. Color Doppler ultrasound was used to detect flow-mediated dilatation （FMD）, and the changes were compared before and after 6-month follow-up among three groups. Results FMD level was （8.36±5.20）% after 6-month follow-up, significantly higher than that before follow-up （（6.05 ± 3.76）%） in decreased volume group （P〈0.05）, and was （6.50±3.27）% after 6-month follow-up, significantly lower than that before follow-up （（9.94± 4.99）%） in increased volume group （P〈0. 01）, and there was no significant difference after follow-up （（6. 81 ±3.80） %） in comparison with that before follow-up （（6.80±5.35）%） in stable volume group （P〉0.05）. At the end of follow-up, FMD level was significantly higher in decreased volume group than that in the other two groups （P〈0.05）. Conclusion The volume is closely longitudinal correlated with FMD in CAPD patients, and has an important influence on endothelial function.