糖尿病与非糖尿病病人腹膜透析初始时的临床状况比较分析

Comparison of clinical status between diabetics and non-diabetics in early peritoneal dialysis

目的 对比分析糖尿病与非糖尿病终末期肾病 (ESRD)病人在腹膜透析 (CAPD)初始时的临床状况 ,初步探讨糖尿病ESRD病人适当的透析时机。方法 入选了 6 7例接受CAPD治疗的年龄 5 0岁以上ESRD患者 ,其中糖尿病组 2 7例 ,非糖尿病组 4 0例。分别对患者的残肾功能、营养状况、合并症情况、活动能力进行评估。结果 与非糖尿病组相比 ,糖尿病组CAPD病人开始透析时的血肌酐质量浓度、血浆白蛋白及握力检测明显低于非糖尿病组 ,而肌酐清除率及营养不良发生率均明显高于非糖尿病组 ;糖尿病组的合并症指数评估明显高于非糖尿病组 ,活动能力明显低于非糖尿病组。统计学检验差异均具有显著性。结论 糖尿病病人透析时机选择应根据病人的残肾功能、临床症状、合并症情况和营养状态综合考虑 ,应及时开始CAPD治疗。

Objective To compare the clinical conditions between the diabetics and non-diabetics at their initiation of peritoneal dialysis.Methods Sixty-seven patients aged over 50 years (27 type 2 diabetic and 40 non-diabetic patients) were included in the study.Patients’ residual renal function,nutritional status,comorbidities and physical activity were evaluated.Results Compared with nondiabetic patients,the serum creatinine,albumin and prealbumin levels,hand grip and physical activity were significantly lower and the nutritional status were significantly worse in diabetic patients,whereas the residual renal function and indices of comorbidity were significantly higher in diabetic patients as compared to nondiabetics.Conclusions The time choice for dialysis is combiningly determined by residual renal function,clinical status,comordity and nutritional status.And CAPP should be in time.