腹膜透析患者透析时间、微炎症及透析充分性与营养状态的关系

刘昊虹　刘威　黄丽芳

【摘要】 目的：探討腹膜透析患者透析时间、微炎症及透析充分性与营养状态的关系。方法：将2015年8月-2017年12月本院肾病科收治的106例持续性不卧床腹膜透析（CAPD）患者作为研究对象。根据患者透析时间分为透析2年以下组46例、透析2～4年组37例、透析4年以上组23例。选择同期本院60例健康体检者临床资料作为对照组。比较不同透析时间患者微炎症状态、透析充分性及营养状态的差异，分析患者微炎症及透析充分性与营养状态关系。结果：透析4年以上组、透析2～4年组、透析2年以下组腹膜透析患者CRP、iPTH、β2-MG、MQSGA均高于对照组，其Kt/V、ALB、MAMC均低于对照组，差异均有统计学意义（P<0.05），上述指标在透析4年以上组、透析2～4年组、透析2年以下组患者，组间两两比较差异均有统计学意义（P<0.05）；随着透析时间的延长，CRP、iPTH、β2-MG、MQSGA水平越高，Kt/V、ALB、MAMC也越低。CRP及iPTH水平与营养状态中MAC、MAMC均成负相关，与MQSGA成正相关（P<0.05），与TSF、BSF、HGS无明显相关性；Kt/V、ALB水平与营养状态中MAC、MAMC均成正相关，与MQSGA呈负相关（P<0.05），与TSF、BSF、HGS无明显相关性。透析时间、Kt/V、ALB、iPTH、CRP、基础性疾病是影响腹膜透析患者营养状态独立影响因素。结论：透析时间长、微炎症及透析不充分是腹膜透析患者营养状态不佳的重要影响因素，也是其独立影响因素，临床上应及早干预和治疗，以提高患者生存质量及生存期。

【关键词】 腹膜透析； 透析时间； 微炎症； 透析充分性； 营养状态

Relationship between Dialysis Time，Micro-inflammation，Dialysis Adequacy and Nutritional Status in Peritoneal Dialysis Patients/LIU Haohong，LIU Wei，HUANG Lifang.//Medical Innovation of China，2018，15（17）：0-018

【Abstract】 Objective：To investigate the relationship between dialysis time，micro-inflammation，dialysis adequacy and nutritional status in peritoneal dialysis patients.Method：106 patients of receiving the continuous ambulatory peritoneal dialysis（CAPD） from August 2015 to December 2017 in our Nephrology Department were selected.The subjects were divided into <2 years group（46 cases），2-4 years group （37 cases） and >4 years group （23 cases） according to the dialysis time.60 health check-ups were selected as control group.The correlation of micro-inflammation and dialysis adequacy with nutritional status was analyzed.Result：The indices of CRP，iPTH， β2-MG and MQSGA for >4 years group，2-4 years group and <2 years group were higher than those in control group（P<0.05）；the indices of Kt/V，ALB and MAMC for >4 years group，2-4 years group and <2 years group were lower than those in control group（P<0.05）；the above indices for >4 years group，2-4 years group and <2 years group were significantly different（P<0.05）；as the dialysis time was extended，the indices of CRP，iPTH，β2-MG and MQSGA were increased while the indices of Kt/V，ALB and MAMC were reduced.The indices of CRP and iPTH were negatively correlated with MAC and MAMC and positively correlated with MQSGA（P<0.05）；the indices of CRP and iPTH had no obvious correlation with TSF，BSF and HGS；the indices of Kt/V and ALB were positively correlated with MAC and MAMC and negatively correlated with MQSGA（P<0.05）；the indices of Kt/V and ALB had no obvious correlation with TSF，BSF and HGS；the independent influence factors of nutritional status included the dialysis time，Kt/V，ALB，iPTH，CRP and basic diseases.Conclusion：The independent influence factors of the poor nutritional status include the long dialysis time，micro-inflammation and dialysis inadequacy，the early intervention and therapy can improve their life quality and survival time.