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目的采用多频生物电阻抗技术评估方法,探讨持续性非卧床腹膜透析(CAPD)患者容量负荷状态及影响因素。方法以2006年1月至2013年12约期间沈阳军区总医院腹膜透析中心管理的60例CAPD患者为研究对象,分析60例无显性水肿CAPD患者的临床资料。结果容量超负荷患者34例(56.67%),该组收缩压、年龄、C-反应蛋白水平均显著高于容量正常组(P<0.05),而Alb、残肾功能、每周尿素和肌酐清除率均低于容量正常组(P均<0.01)。炎症组(31例)平均年龄(P<0.05)、细胞外液(ECW)/身体总液体(TBW)比值(P<0.01)以及收缩压水平(P<0.01)均高于非炎症组(29例);白蛋白(Alb)、每周肌酐清除率水平均低于非炎症组,差异有统计学意义(P<0.01)。容量负荷与年龄、收缩压、C反应蛋白(CRP)呈正相关,与Alb、TP呈负相关(P均<0.01)。结论 (1)采用多频生物电阻抗技术可更早发现CAPD患者的容量失衡;(2)年龄、收缩压、残肾功能、尿素清除率、白蛋白、C-反应蛋白均是CAPD患者容量负荷的影响因素;(3)CAPD患者容量负荷与年龄、营养状态及炎症密切相关。
Objective To evaluate the capacity load status and influencing factors in patients with continuous ambulatory peritoneal dialysis (CAPD) by multi-frequency bioelectrical impedance technique. Methods Sixty patients with CAPD managed by Perianal Dialysis Center of Shenyang Military Region General Hospital from January 2006 to December 2013 were included in the study. Clinical data of 60 patients with CAPD without obvious edema were analyzed. Results The patients with volume overload had 34 cases (56.67%). The systolic blood pressure, age and C-reactive protein level were significantly higher than those of normal volume group (P <0.05), while Alb, residual renal function, weekly urea and creatinine clearance The rates were lower than the normal volume group (all P <0.01). The average age (P <0.05), ECW / TBW (P <0.01) and systolic blood pressure (P <0.01) in the inflammation group were significantly higher than those in the non-inflammatory group Cases), albumin (Alb), weekly creatinine clearance rate were lower than non-inflammatory group, the difference was statistically significant (P <0.01). The volume load was positively correlated with age, systolic blood pressure and C-reactive protein (CRP) and negatively correlated with Alb and TP (all P <0.01). Conclusions (1) The capacity imbalance of CAPD patients can be detected earlier by multi-frequency bioelectrical impedance technique. (2) Age, systolic pressure, residual renal function, urea clearance, albumin and C-reactive protein (3) CAPD patients with capacity load and age, nutritional status and inflammation are closely related.