本文選題：腹膜透析 + 腹膜通透性�。� 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:探討不同腹膜通透性對(duì)持續(xù)不臥床腹膜透析(CAPD)患者左心室結(jié)構(gòu)的影響。方法:選擇山西醫(yī)科大學(xué)附屬第一醫(yī)院腎內(nèi)科行腹膜透析患者45例,通過(guò)腹膜平衡試驗(yàn)(PET)判斷腹膜轉(zhuǎn)運(yùn)功能,依照PET結(jié)果分為2組:高通透性組(H);低通透性組(L)。對(duì)所以入選的患者,將其透析前及透析12個(gè)月后,檢測(cè)患者體內(nèi)血紅蛋白量(Hb)、血清白蛋白(ALB)、血鈉、血氯、血鈣、血磷、血漿甲狀旁腺素(PTH)、總膽固醇(TC)、甘油三酯(TG)、C反應(yīng)蛋白(CRP)等臨床指標(biāo);檢測(cè)患者血、尿及腹透液中的尿素氮(BUN)濃度、肌酐(Cr)濃度及血糖濃度,根據(jù)公式計(jì)算出患者尿素清除指數(shù)(KT/V)及殘余腎小球?yàn)V過(guò)率,作為殘余腎功能(RRF)評(píng)估的指標(biāo)。同時(shí)收集患者心臟彩超結(jié)果,包括室間隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室舒張末內(nèi)徑(LVDd),并根據(jù)Reichek公式計(jì)算左心室心肌重量指數(shù)(LVMI)并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.腹膜透析患者中LVMI與CRP及腹膜通透性呈正相關(guān)(r=0.328、0.427,P0.05),與Hb、ALB、RRF、KT/V呈負(fù)相關(guān)(r=-0.423、-0.383、-0.316、-0.317,P0.05);2.與腹膜低通透性的患者比較,腹膜高通透性的患者血紅蛋白[(95.00±11.42)g/L比(112.25±8.39)g/L,P0.001]、白蛋白[(30.68±3.78)g/L比(40.09±4.35)g/L,P0.001]、RRF[(1.17±0.59)ml/min比(3.41±1.23)ml/min,P0.001]、KT/V[(1.85±0.47)比(2.32±0.83),P=0.035]明顯降低,CRP[(4.53±3.72)mg/d L比(1.45±0.85)mg/d L,P=0.001]、LVMI[(147.75±25.33)g/m2比(110.31±30.41)g/m2,P=0.001]明顯升高。結(jié)論:高通透性的腹膜透析患者左心室肥厚發(fā)生高于低通透性的腹膜透析患者,可能與營(yíng)養(yǎng)不良、微炎癥、透析不充分、殘余腎功能下降有關(guān)系,提示我們應(yīng)該早期對(duì)腹膜高通透性患者進(jìn)行干涉。
[Abstract]:Aim: to investigate the effect of different peritoneal permeability on left ventricular structure in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods: Forty-five patients with peritoneal dialysis in the Department of Renal Medicine affiliated to the first affiliated Hospital of Shanxi Medical University were selected. Peritoneal transport function was evaluated by peritoneal balance test. According to the results of PET, they were divided into two groups: high permeability group and low permeability group. Before and 12 months after dialysis, the hemoglobin content, serum albumin, serum sodium, blood chlorine, blood calcium, blood phosphorus were measured. Plasma parathyroid hormone (PTH), total cholesterol (TC), triglyceride (TG) and C-reactive protein (CRP) were measured in blood, urine and peritoneal dialysate, and blood urea nitrogen (bun), creatinine (Cr) and blood glucose were measured. The urea clearance index (KT / V) and residual glomerular filtration rate (GFR) were calculated according to the formula. At the same time, the results of color Doppler echocardiography were collected, including septal thickness (IVST), left ventricular posterior wall thickness (LVPWTT), left ventricular end-diastolic diameter (LVDdD), and the left ventricular mass index (LVMI) calculated by Reichek formula. The result is 1: 1. In peritoneal dialysis patients, there was a positive correlation between LVMI and CRP and peritoneal permeability. There was a negative correlation between LVMI and CRP, and a negative correlation between LVMI and RRFRF / V in hemodialysis patients. 涓庤吂鑶滀綆閫氶，

本文編號(hào)：1966417