本文選題：腹膜透析 + 殘余腎功能�。� 參考：《河北醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:探討維持性腹膜透析患者殘余腎功能與鈣磷代謝異常及心功能間的關(guān)系,為改善腹膜透析患者心功能及預(yù)后提供臨床參考。方法:收集行維持性腹膜透析的老年ESRD患者63例,根據(jù)其殘余腎功能(GFR)水平將患者分為0~2ml組(GFR2ml/min/1.73m2),2~4ml組(GFR為2~4ml ml/min/1.73m2),4ml組(GFR4 ml/min/1.73m2)。比較各組的一般情況及血鈣、血磷水平、鈣磷乘積、心臟鈣化及左心室舒張末期內(nèi)徑(LVEDD)、收縮末期內(nèi)徑(LVEDS),室間隔厚度(ⅣST),左心室后壁厚度(LVPWT),射血分?jǐn)?shù)(EF)的情況。同時分析殘余腎功能指標(biāo)GFR與血磷水平、鈣磷乘積、心臟鈣化及EF間的相關(guān)性。結(jié)果:63例腹膜透析患者平均血鈣水平為(2.45±0.41)mmol/L,血磷水平為(1.95±0.51)mmol/L,血甲狀旁腺素水平為(167.8±91.2)pg/ml。心血管鈣化率為47.6%。2~4ml組的透析時間明顯短于0~2ml組,4ml組的透析時間明顯短于2~4ml組(P0.05);2~4ml組營養(yǎng)差的比例低于0~2ml組,4ml組的營養(yǎng)差的比例低于2~4ml組(P0.05)。2~4ml組、4ml組LVEDD、LVEDS、ⅣST、LVPWT明顯低于0~2ml組(P0.05),EF明顯高于0~2ml組(P0.05);4ml組LVEDD、LVEDS、ⅣST、LVPWT明顯低于2~4ml組,EF明顯高于2~4ml組(P0.05)。Pearson相關(guān)性分顯示,患者GFR水平與血磷、鈣磷乘積、心臟鈣化呈負(fù)的相關(guān)性(r=-0.532,-0.639,-475,P0.05),與心臟功能指標(biāo)EF呈正的相關(guān)性(r=0.835,P0.05)。結(jié)論:保護(hù)殘余腎功能,控制血磷水平及降低鈣磷乘積,合理使用活性維生素D3,以降低腹透患者心血管鈣化的風(fēng)險,對改善患者心功能,降低死亡率有著積極的意義。
[Abstract]:Objective: to investigate the relationship between residual renal function, calcium and phosphorus metabolism and cardiac function in patients with maintenance peritoneal dialysis, and to provide clinical reference for improving cardiac function and prognosis of peritoneal dialysis patients. Methods: 63 elderly patients with maintenance peritoneal dialysis were divided into two groups according to their residual renal function (GFR): 0~2ml group (GFR2ml / min / 1.73m2) group (GFR2ml / 1.73m2) group (GFR = 2~4ml ml/min/1.73m2) 4ml group (GFR4 ml/min/1.73m2). The blood calcium, serum phosphorus level, calcium and phosphorus product, cardiac calcification and left ventricular end-diastolic diameter (LVEDD), end-systolic diameter (LVEDS), interventricular septal thickness (鈪，

本文編號：2115164