腹膜透析患者固有腹膜高转运的相关因素分析-东南大学学报医学版

腹膜透析患者固有腹膜高转运的相关因素分析

单位：南京大学医学院附属鼓楼医院肾内科, 江苏南京 210008

分类号：R692.5

出版年·卷·期（页码）：2016·35·第一期（16-20）

摘要：

目的:探讨国人固有型腹膜高转运患者的临床特点及其相关因素。方法:回顾性总结2011年1月至2014年6月因终末期肾脏病行腹膜透析置管的194例患者的临床资料,将患者按照透析开始后的腹膜转运特性分为低转运组(21例)、低平均转运组(55例)、高平均转运组(93例)和高转运组(25例)4组,比较患者人口学资料、透析前的生化指标以及白介素6(interleukin-6,IL-6)基因单核苷酸多态性;Logistic回归分析患者腹膜高转运的独立危险因素。结果:4组患者性别分布、心血管并发症以及钙磷乘积水平存在显著差异(P<0.05);4组患者中,IL-6基因T15A多态性分布有显著差异(P<0.05)。回归分析显示,钙磷乘积、心血管并发症以及IL-6基因T15A多态性是本组患者腹膜高转运的独立危险因素。结论:腹膜透析患者透析前钙磷乘积水平、心血管并发症以及IL-6基因T15A多态性可能与国人腹膜高转运有关。

Objective:To investigate the clinical characteristics and factors associated with intrinsically high peritoneal transport rate in peritoneal dialysis (PD) patients. Methods:During the period from January 2011 to June 2012, the clinical data of 194 newly started PD patients were collected for ananlysis in this study. Patients were divided into four groups:low (L,n=21),low average (LA,n=55), high average (HA,n=93) and high (H,n=25) peritoneal transport rate groups, according to their categories of peritoneal transport rate defined by the result of peritoneal equilibration test (PET). The clinical data and IL-6 genotypes were compared across the groups. And multiple Logistic regression analysis was used to determine the independent factors associated with high peritoneal transport rate. Results:Significant difference on the gender, history of cardiovascular complications, and serum level of calcium phosphorus product were found among the groups(P<0.05).The distribution of genotypes of IL-6 T15A polymorphism among the groups was significantly different from each other. Logistic regression analysis showed that the history of cardiovascular complications, serum levels of calcium phosphorus product, and IL-6 T15A polymorphism were independent risk factors for high peritoneal transport rate(P<0.05). Conclusion:The history of cardiovascular complications, high serum level of calcium phosphorus product, as well as IL-6 T15A polymorphism may be useful markers in predicting the high peritoneal transport rate before PD.

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