本文選題：腹膜透析　切入點(diǎn)：持續(xù)不臥床　出處：《重慶醫(yī)學(xué)》2017年23期 　論文類型：期刊論文

【摘要】：目的探討微炎癥狀態(tài)和蛋白質(zhì)能量消耗(PEW)在維持性腹膜透析(MPD)患者中發(fā)病特點(diǎn),分析其相關(guān)性。方法選擇2012年3月至2015年9月該院收治的MPD患者96例。采用改良SGA法、漢化營養(yǎng)不良原炎癥評(píng)分(SMI)評(píng)分和清蛋白(Alb)進(jìn)行營養(yǎng)評(píng)估,微炎癥狀態(tài)評(píng)估采用酶聯(lián)免疫吸附試驗(yàn)(ELISA)法檢測(cè)血漿超敏C反應(yīng)蛋白(hs-CRP)、腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素6(IL-6)水平,同時(shí)檢測(cè)Alb、血清總蛋白(TP)、前清蛋白(PA)、血紅蛋白(Hb)、轉(zhuǎn)鐵蛋白(TF)、血肌酐(Scr)、血尿素氮(BUN)、血清膽固醇(Tch)等指標(biāo)。結(jié)果 MPD患者PEW發(fā)生率36.50%,其中大于65歲患者占62.86%,透析齡大于2年患者占57.10%,糖尿病腎病患者占40.00%;MPD患者h(yuǎn)s-CRP5 mg/L占58.33%,其中大于65歲患者占42.86%,透析齡大于2年患者占60.71%,糖尿病腎病患者占32.14%。PEW組糖尿病腎病患者、年齡、透析齡、hs-CRP、TNF-α、IL-6高于非PEW組,而BMI、TP、Alb、PA、Hb、Tch、中臂圍(MAC)、中臂肌圍(MAMC)的比例低于非PEW組(均P0.05);hsCRP5mg/L組年齡、透析時(shí)間、TNF-α、IL-6高于hs-CRP≤5 mg/L組,而TP、Alb、PA、TF、Hb、Kt/V≥1.72的比例低于hsCRP≤5mg/L組(均P0.05)。校正性別、年齡、透析齡影響因素,MPD患者h(yuǎn)s-CRP水平與Alb、PA、TF、Tch、Scr、TG水平呈不同程度負(fù)相關(guān);患者IL-6水平分別與Alb、PA、TF、Tch、TG呈不同程度負(fù)相關(guān);患者TNF-α水平與Alb、PA、TF、TG、Tch水平呈不同程度負(fù)相關(guān)(均P0.05)。多因素分析顯示,高齡、透析齡、微炎癥狀態(tài)、低蛋白血癥是PEW的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論 MPD患者PEW、微炎癥狀態(tài)發(fā)生率高,PEW、微炎癥狀態(tài)發(fā)生具有高齡、透析齡長(zhǎng)的特點(diǎn),糖尿病患者更易并發(fā)PEW、微炎癥狀態(tài),高齡、透析齡、微炎癥狀態(tài)、低蛋白血癥是PEW的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the characteristics of microinflammation and protein energy consumption (PEW) in patients with maintenance peritoneal dialysis (MPD) and to analyze their correlation. Methods 96 patients with MPD were selected from March 2012 to September 2015. The levels of plasma hypersensitive C-reactive protein (hs-CRPN), tumor necrosis factor- 偽 (TNF- 偽) and interleukin-6 (IL-6) in plasma were measured by enzyme-linked immunosorbent assay (Elisa). At the same time, Alb, serum total protein (TTP), prealbumin (PAA), hemoglobin (HB), transferrin (TFN), creatinine (Cr), bun (bun), serum cholesterol (TC) were detected. Results the incidence of PEW in MPD patients was 36.50, of which 62.86b was more than 65 years old, and the dialysis age was older than 65 years. The patients with diabetic nephropathy accounted for 57.10% of the total, and the patients with diabetic nephropathy accounted for 58.33% of hs-CRP5 mg/L, including 42.86% of the patients over 65, 60.71% of the patients with dialysis older than 2 years, and 60.71% of the patients with diabetic nephropathy, and the patients with diabetic nephropathy accounted for the patients with diabetic nephropathy in the 32.14%.PEW group. Age, age, hemodialysis age, TNF- 偽 IL-6 of hs-CRPU TNF- 偽 group was higher than that of non-#en1# group, while the ratio of BMI-TPTPPABPA-PAHbTch, middle arm circumference (MAC), middle arm muscle (MAC) group was lower than that of non-#en1# group (all P0.05hsCRP5mg / L age, dialysis time was higher than that of hs-CRP 鈮，

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