【摘要】 目的:探讨腹膜透析(PD)患者经透析液丢失蛋白质的影响因素。方法:对123例PD患者进行回顾性研究。检测患者的血清白蛋白(Alb)、三酰甘油、铁蛋白、24h尿蛋白定量、24h透析液蛋白等生化指标,计算尿素清除指数(Kt/V)、标准腹膜平衡试验(PET),观察透析液蛋白量与血尿生化指标、透析方案等的关系。结果:PD患者平均24h透析液蛋白量4.13±1.64g,与Alb显著负相关(r=-0.219,P=0.015)。所有患者根据Alb水平分为<35 g/L和≥35 g/L两组,低白蛋白血症组(Alb<35 g/L)患者24h透析液蛋白量明显高于另一组[(4.82±1.80)g vs(3.88±1.52)g,P=0.005]。24h透析液蛋白量与每日透析时间(r=0.22,P=0.014)、2.5%透析液透析时间比(r=0.19,P=0.035)及4h肌酐D/P值(r=0.386,P=0.000 3)呈正相关。低转运组透析液蛋白量(2.87±1.52g)明显少于低平均转运组(4.30±1.65g)和高平均转运组(4.71±1.54g;F=7.46,P=0.001)。此外,连续不卧床腹膜透析(CAPD)患者透析液蛋白量与血清三酰甘油负相关(r=-0.297,P<0.05),日间不卧床腹膜透析(DAPD)患者透析液蛋白量与血红蛋白负相关(r=-0.413,P<0.01)。结论:PD患者每日经透析液丢失较多蛋白质,丢失量与Alb、血红蛋白、腹膜转运特性和透析方案等因素有关。更多还原

【Abstract】 Objective: To explore the influencing factors of daily protein loss from peritoneal dialysis solutions( PDS) in patients with peritoneal dialysis( PD). Methodology: One hundred twenty three PD patients in our center were included in the retrospective study. Serum albumin( Alb),serum triglyceride,ferritin,24 hours urinary protein,peritoneal protein leakage,standard peritoneal equilibration test( PET) and urea clearance index( Kt/V) were measured to observe the relationship of peritoneal protein loss with dialysis prescriptions,blood and urine biochemical parameters.Results: The mean protein loss in 24 hours dialysate effluent was 4. 13± 1. 64 g,which was negatively correlated with Alb( r=-0. 219,P= 0. 015). All patients were divided into two groups according to Alb <35 g/L or ≥35 g/L,24 h peritoneal protein loss was( 4. 82±1. 80) g in hypoalbuminemia group,significantly higher than the other group 3. 88 ± 1. 52 g( P =0. 005). Protein loss was positively correlated with duration of daily dialysis( r = 0.22,P = 0. 014),time ratio of 2. 5% PDS( r= 0. 19,P= 0. 035) and 4 h D/P creatinine level( r= 0. 386,P= 0. 000 3). Peritoneal protein loss of low transport group( 2. 87±1. 52 g) was significantly lower than low average transport group( 4. 30±1. 65 g) and high average transport group( 4. 71±1. 54 g; F = 7. 46,P = 0. 001). In addition,protein loss was negatively correlated with serum triglycerides( r =-0. 297,P<0. 05) in continuous ambulatory peritoneal dialysis( CAPD) patients and hemoglobin( r =-0. 413,P < 0. 01)in daytime ambulatory peritoneal dialysis( DAPD). Conclusion: Peritoneal protein loss was significant in PD,which was associated with Alb,hemoglobin,peritoneal transport characteristics and dialysis prescriptions.更多还原