目的探讨腹膜透析患者管理对持续性非卧床腹膜透析（CAPD）患者生活质量的影响。方法将2000年6月～2007年6月于该院行CAPD治疗的97例现存患者纳入研究。其中管理组49例，非管理组48例。管理组在本腹膜透析中心接受长期的患者管理，包括...目的探讨腹膜透析患者管理对持续性非卧床腹膜透析（CAPD）患者生活质量的影响。方法将2000年6月～2007年6月于该院行CAPD治疗的97例现存患者纳入研究。其中管理组49例，非管理组48例。管理组在本腹膜透析中心接受长期的患者管理，包括管理前的评估、长期门诊和家庭随访；非管理组则进行常规的电话随访和指导。以KDQOL-SFTM量表评估患者生活质量。使用汉密尔顿抑郁量表（HAWD）评估患者的抑郁症状，以主观全面营养评估法（subjective global assessment，SGA）、血清白蛋白（ALB）、血红蛋白（Hb）指标评估营养状况，以腹膜尿素清除指数（Kt／Vurea）评估腹膜清除效能，患者24h尿量评估残存肾功能。干预后1年进行回顾性对照分析，评价腹透管理对CAPD患者生活质量及相关因素的影响，同时观察腹透管理对不同透析时间的CAPD患者生活质量改善的差异。结果管理组腹透患者管理后透析相关生活质量评分均高于管理前及非管理组（P〈0．05），Hamilton抑郁评分低于管理前及非管理组（P〈0．01），SGA、AIb及Kt／V均较管理前及非管理组提高（P〈0．05）。管理组及非管理组患者残存肾功能均呈下降趋势，组间差异无显著性（P〉0．05）。管理组以不同透析时间划分的三个亚组患者在管理后KDTA及SF-36评分均高于非管理组对应亚组，且以腹透时间≤1年组提高最为明显。结论腹膜透析患者管理能从多个方面提高CAPD患者的生活质量，且对提高早期腹膜透析患者生活质量意义重大。展开更多
It consists of a retrospective study with twenty-two individuals diagnosed with DRC: fourteen HD and eight CAPD, followed up in the dialysis center of Antonio Pedro University Hospital (HUAP) of Fluminense Federal Uni...It consists of a retrospective study with twenty-two individuals diagnosed with DRC: fourteen HD and eight CAPD, followed up in the dialysis center of Antonio Pedro University Hospital (HUAP) of Fluminense Federal University (UFF), between 2015 and 2017. Fifteen healthy control (HC) subjects were included, without diagnosed CKD. Patients with HIV positive, hepatitis A, B, and C, pregnant, cancer, smokers, alcoholics and those exposed to X-rays in the last 3 months, were excluded. Objectives: As oxidative stress and endothelial dysfunction may be linked to the higher prevalence of CVD in CKD patients, we measured the activities of the antioxidants enzymes: SOD and GPx and total NO levels in the plasma and serum of end-stage CKD patients undergoing dialysis therapy, comparing with the HC group. Methods: Quantification of NO levels was performed by fluorometric kit, while activities of SOD and GPx were determined using kinetic methods. Results: We found higher plasma SOD activity in HD (8.58 U/ml) and CAPD (10.14 U/ml), compared to C (3.73 U/ml) group, while GPx activity was decreased in HD (115.38 nmol/h/ml) and CAPD (122.76 nmol/h/ml) groups compared to HC group (275.83 nmol/h/ml). Total serum NO concentration was decreased in HD (14.09 pmol/μl) and CAPD (10.26 pmol/μl), compared to non-CKD patients (49.65 pmol/μl). Conclusion: Decreased total serum NO and GPx activities may lead to endothelial dysfunction and consequently a higher prevalence of CVD in CKD patients.展开更多
文摘目的探讨腹膜透析患者管理对持续性非卧床腹膜透析（CAPD）患者生活质量的影响。方法将2000年6月～2007年6月于该院行CAPD治疗的97例现存患者纳入研究。其中管理组49例，非管理组48例。管理组在本腹膜透析中心接受长期的患者管理，包括管理前的评估、长期门诊和家庭随访；非管理组则进行常规的电话随访和指导。以KDQOL-SFTM量表评估患者生活质量。使用汉密尔顿抑郁量表（HAWD）评估患者的抑郁症状，以主观全面营养评估法（subjective global assessment，SGA）、血清白蛋白（ALB）、血红蛋白（Hb）指标评估营养状况，以腹膜尿素清除指数（Kt／Vurea）评估腹膜清除效能，患者24h尿量评估残存肾功能。干预后1年进行回顾性对照分析，评价腹透管理对CAPD患者生活质量及相关因素的影响，同时观察腹透管理对不同透析时间的CAPD患者生活质量改善的差异。结果管理组腹透患者管理后透析相关生活质量评分均高于管理前及非管理组（P〈0．05），Hamilton抑郁评分低于管理前及非管理组（P〈0．01），SGA、AIb及Kt／V均较管理前及非管理组提高（P〈0．05）。管理组及非管理组患者残存肾功能均呈下降趋势，组间差异无显著性（P〉0．05）。管理组以不同透析时间划分的三个亚组患者在管理后KDTA及SF-36评分均高于非管理组对应亚组，且以腹透时间≤1年组提高最为明显。结论腹膜透析患者管理能从多个方面提高CAPD患者的生活质量，且对提高早期腹膜透析患者生活质量意义重大。
文摘It consists of a retrospective study with twenty-two individuals diagnosed with DRC: fourteen HD and eight CAPD, followed up in the dialysis center of Antonio Pedro University Hospital (HUAP) of Fluminense Federal University (UFF), between 2015 and 2017. Fifteen healthy control (HC) subjects were included, without diagnosed CKD. Patients with HIV positive, hepatitis A, B, and C, pregnant, cancer, smokers, alcoholics and those exposed to X-rays in the last 3 months, were excluded. Objectives: As oxidative stress and endothelial dysfunction may be linked to the higher prevalence of CVD in CKD patients, we measured the activities of the antioxidants enzymes: SOD and GPx and total NO levels in the plasma and serum of end-stage CKD patients undergoing dialysis therapy, comparing with the HC group. Methods: Quantification of NO levels was performed by fluorometric kit, while activities of SOD and GPx were determined using kinetic methods. Results: We found higher plasma SOD activity in HD (8.58 U/ml) and CAPD (10.14 U/ml), compared to C (3.73 U/ml) group, while GPx activity was decreased in HD (115.38 nmol/h/ml) and CAPD (122.76 nmol/h/ml) groups compared to HC group (275.83 nmol/h/ml). Total serum NO concentration was decreased in HD (14.09 pmol/μl) and CAPD (10.26 pmol/μl), compared to non-CKD patients (49.65 pmol/μl). Conclusion: Decreased total serum NO and GPx activities may lead to endothelial dysfunction and consequently a higher prevalence of CVD in CKD patients.
