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氨基酸腹膜透析对腹膜透析患者透析效能和营养状况的影响

孙彬,李雪芹,马强   

  1. 即墨市医院肾脏病科,即墨市医院肾脏病科,解放军总医院老年肾脏病科
  • 收稿日期:2019-01-10 修回日期:2019-01-10 出版日期:2019-01-25

Effects of Amino Acid Peritoneal Dialysis on Dialysis Efficiency and Nutritional Status of CAPD Patients

SUN Bin,LI Xueqin and MA Qiang   

  1. Department of Nephrology,the People’s Hospital of Jimo,Shandong Qingdao,Department of Nephrology,the People’s Hospital of Jimo,Shandong Qingdao,Department of Geriatric Nephrology,PLA General Hospital
  • Received:2019-01-10 Revised:2019-01-10 Online:2019-01-25

摘要: 目的:研究氨基酸腹膜透析对腹膜透析患者透析效能和营养状况的影响。方法:选取持续不卧床腹膜透析(CAPD)住院患者21例,采用自制的氨基酸腹膜透析液,白天的3袋为正常腹膜透析液,夜间以氨基酸腹膜透析液留腹8 h左右,应用8周,观察CAPD患者尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、血白蛋白(ALB)、血红蛋白(HB)、血钙(Ca)、血磷(P)等生化指标变化情况以及不良反应发生情况。结果:1.5%腹膜透析液渗透压为341 mOsm/kg·H2O,加入复方氨基酸注射液后,渗透压提高到365~379 mOsm/kg·H2O,与2.5%腹膜透析液渗透压基本相似,但单袋出超量较1.5%及2.5%腹膜透析液增加。治疗8周后,患者血ALB由(27.49±3.82)g·L-1增加到(28.64±4.41)g·L-1(P<0.05);多数患者血ALB水平升高,最高增幅为8 g·L-1左右。患者血BUN、UA、血P水平均降低(P<0.05),血HB水平升高(P<0.05),但血Cr及血Ca水平变化差异无统计学意义(P>0.05)。治疗过程中,5例患者出现短暂恶心、呕吐,未观察到有腹痛、腹泻及腹膜炎的发生。结论:应用自制的氨基酸腹膜透析液对CAPD患者进行夜间留腹治疗,可有效提高患者的透析效能,并改善营养状态,纠正营养不良,且无明显不良反应。

Abstract: Objective:To study the effects of amino acid peritoneal dialysis on dialysis efficiency and nutritional status of continuous ambulatory peritoneal dialysis(CAPD)patients. Methods:21 cases of CAPD patients were treated with self-made amino acid peritoneal dialysis fluid.The patients were given three bags of normal peritoneal dialysis solution during the day,and amino acid peritoneal dialysis solution at night for about 8 h, and the changes of biochemical indexes such as urea nitrogen(BUN),creatinine(Cr),uric acid (UA),serum albumin(ALB), haemoglobin(HB),serum calcium (Ca) and blood phosphorus (P) of CAPD patients and the occurrence of adverse reactions were observed for 8 weeks. Results:The osmotic pressure of 1.5% peritoneal dialysis solution was 341 mOsm/kg·H2O, after adding compound amino acid injection, the osmotic pressure increased from 365 to 379 mOsm/kg·H2O, similar to the osmotic pressure of 2.5% peritoneal dialysis solution, but the dialysis dehydration was higher than that of 1.5% and 2.5% peritoneal dialysis solution. After treated with amino acid peritoneal dialysis solution for 8 weeks, the ALB levels of the patients were increased from (27.49±3.82) g·L-1 to (28.64±4.41) g·L-1(P<0.05). Most patients have elevated levels of ALB, and the highest increase was about 8 g·L-1.The levels of blood BUN, UA and P of the patients were all decreased (P<0.05),the levels of HB were increased (P<0.05), but the levels of serum Cr and Ca did not changed significantly, the difference was not statistically significant (P>0.05). During the treatment, 5 patients had transient nausea and vomiting. No abdominal pain, diarrhea and peritonitis were observed.Conclusion:Amino acid peritoneal dialysis can increase dialysis efficiency and improve nutritional status of CAPD patients,and there was no obvious side effects.