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目的腹膜透析(peritoneal dialysis,PD)患者超滤量可受到腹膜功能、尿量、营养状态、透析方式等诸多因素的影响,而且有无残肾功能患者的超滤量显然会受到不同因素的影响,故分析这些因素在超滤中发挥的作用可为控制PD患者体液平衡和改善其生存状况提供参考。方法选择武汉市第一医院符合纳入标准的PD患者178例,以UF的四位数将入选患者分成四组(UF1、UF2、UF3、UF4),再将所有患者按有无残肾功能(residual renal function,RRF)分为2组,有RRF组和无RRF组。收集各项临床资料,并计算残肾Kt/V、残肾肌酐清除率(Ccr)等值。最后将具有统计意义的相关因素与总UF、有RRF组UF、无RRF组UF做多重线性回归,评估各因素在UF中发挥的作用。结果无RRF患者组与UF相关的因素有体质量指数(body/mass index,BMI)(P<0.01)和留腹时间(P<0.05);有RRF患者组与UF呈正相关的因素有2.5%葡萄糖透析液(P<0.01)、腹膜运转功能(D/P值)(P<0.05),呈负相关的因素为残肾Kt/V(P<0.01)和SGA评分(P<0.05)。D/P值随腹膜炎发生次数的增多而逐渐增加。多重线性回归分析发现D/P和2.5%葡萄糖透析液是影响总UF的因素,D/P的影响更大;残肾Kt/V、D/P和2.5%葡萄糖透析液是有RRF者UF的影响因素,残肾Kt/V的影响最大;BMI是无RRF患者UF的独立影响因素。结论 D/P是影响PD患者’UF的主要因素,RRF是有RRF者UF的主要影响因素,BMI是无RRF者UF的独立影响因素。因而保护PD患者的腹膜功能和RRF,监测无RRF患者的体质量,避免其增长或减少过快是合理控制PD患者UF的重要方式。
Objective Peritoneal dialysis (PD) in patients with ultrafiltration volume may be affected by peritoneal function, urine output, nutritional status, dialysis and many other factors, and with or without residual renal function in patients with ultrafiltration volume is clearly subject to different factors Therefore, analyzing the role of these factors in ultrafiltration can provide reference for controlling the body fluid balance and improving the survival status of PD patients. Methods One hundred and eighty-eight patients with PD were enrolled in the First Hospital of Wuhan. The patients were divided into four groups (UF1, UF2, UF3, UF4) by four digits of UF, and all patients were divided into four groups according to the residual renal function renal function, RRF) were divided into two groups, RRF group and no RRF group. The clinical data were collected and the Kt / V and Ccr values of residual kidney were calculated. Finally, statistically significant related factors with the total UF, with the RRF group UF, no RRF group UF do multiple linear regression to assess the role of various factors in the UF. Results There was body mass index (BMI) and duration of urinary retention (P <0.05) in UF-free patients with UF. The positive correlation between UF and RRF patients was 2.5% Glucose dialysate (P <0.01), peritoneal function (D / P) (P <0.05). The negative correlation was Kt / V (P <0.01) and SGA (P <0.05) D / P value with the increase in the number of peritonitis and gradually increased. Multiple linear regression analysis showed that D / P and 2.5% glucose dialysate were the factors influencing total UF, and D / P was more affected. The residual kidney Kt / V, D / P and 2.5% glucose dialysate were those with RRF The most influential factors were residual kidney Kt / V; BMI was the independent influencing factor of UF in patients without RRF. Conclusions D / P is the main factor influencing UF in PD patients. RRF is the main influencing factor of UF with RRF, and BMI is the independent influencing factor of UF without RRF. Thus protecting the peritoneal function and RRF of PD patients and monitoring the body weight of patients without RRF and avoiding their growth or reducing too fast is an important way to rationally control the UF of PD patients.