CAPD患者腹膜电荷屏障与腹膜透析液蛋白质丢失的关系.pdfVIP

中国血液净化2008年11月第7卷第11期 Chinese Journal of Blood Purification, November 12, 2008, Vol.7, No.11 ·585· ·论著 · CAPD患者腹膜电荷屏障与腹膜透析液蛋白质丢失的关系 11 22 1 1 俞国庆 文 文 陈 建 庄永泽 【摘要】目的 测定持续非卧床腹膜透析(CAPD)患者腹膜电荷屏障，并对原发病为糖尿病肾病(DN) 与慢性肾小球肾炎(CGN)的CAPD患者的腹膜电荷屏障以及腹膜透析液蛋白进行比较，进而探讨CAPD患者腹 膜电荷屏障与腹膜透析液蛋白丢失的相关性。方法 选择32例CAPD患者，收集血清以及腹膜透析液， 采用清除法测定胰淀粉酶清除率(Cpam)以及唾液淀粉酶的清除率(Csam)的比值(Cpam/Csam)用以评价腹膜 电荷屏障；同时测定腹膜透析液蛋白的丢失量。结果 ①32例CAPD患者腹膜Cpam/Csam的比值为(6.296 ±21.514)；腹膜透析液蛋白为(4.14±1.91)g；②CGN组腹膜透析液蛋白显著低于DN组[(4.35±1.88)g 比 (5.61±0.86)g，P＝0.011＜0.05]；而CGN组Cpam/Csam的比值显著高于DN组[(9.94±28.35)比 (0.68±0.86)，P＝0.017＜0.05]。③所有患者Cpam/Csam与腹膜透析液蛋白丢失量之间具有显著负相 关，相关系数为-0.584，P＜0.01。而且其自然对数与腹膜透析液蛋白丢失量呈直线负相关。结论 CAPD 患者腹膜电荷屏障的丢失可增加腹膜透析液蛋白的漏出。 【关键词】持续非卧床腹膜透析； 腹膜； 电荷屏障； 淀粉酶 中图分类号：R459.5文献标识码：A The relationship between peritoneal charge barrier and peritoneal protein loss in continuous ambulatory 1 2 1 1 1 peritoneal dialysis patients YU Guo-qing , WEN wen , CHEN Jian , ZH UAN G Yong-ze Dep artment of Nep hrology, 2Dep artment of Resp iratology, Fuzhou General Hosp ital, Fuzhou 350025, China 【Abstract 】 Obj ective To investigate the relationship between p eritoneal charge barrier and peritoneal protein loss in continuous ambulatory p eritoneal dialysis (CAPD) patients, we determined the peritoneal charge barrier and then compared the charge barrier and peritoneal protein loss between CAPD patients with the primary disease of diab etes nephropathy (DN group) and those with the primary disease of chronic glomerulonephritis (CGN group). Method Blood sample and peritoneal fluid were collected. Peritoneal charge barrier was evaluated by the ratio of clearance of pancreatic isoamylase (Cpam) to clearance of salivary isoamylase (Csam) (Cpam/Csam). Protein loss in peritoneal fluid was measured as well