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目的通过腹膜平衡试验(PET)探讨我国慢性腹膜透析(PD)儿童腹膜转运特性特点。方法对6例持续性非卧床腹膜透析(cAPD)患儿(2～14岁)行10次儿童标准 PET,参照 Twardowski和儿科腹膜透析联盟(PPDSC)标准评价腹膜溶质转运类型。结果本组患儿首次 PET 于 PD 开始后平均(38.7±15.6)d 进行。4 h 肌酐清除率(4 h-D/P)和4 h 葡萄糖吸收率(4 h-D/D_0)分别为(0.85±0.24)、(0.34±0.19)。依 Twardowski 和 PPDSC 腹膜转运类型评价标准,本组腹膜溶质转运类型分别为高转运型6例(6/10)、高平均转运型1例(1/10)、低平均转运型3例(3/10),无一例低转运型;两种标准分型的总符合率100%。本组腹膜葡萄糖转运类型分别为高转运型3例(3/10)、高平均转运型4例(4/10)、低平均转运型1例(1/10),低转运型2例(2/10);两种标准分型的总符合率90%。连续 PET 显示转运类型变化不一,腹膜炎后4 h-D/P 升高。结论本组 CAPD 儿童腹膜溶质和葡萄糖转运类型均以高转运和高平均转运为主(7/10),呈偏态分布,提示儿童腹透溶质清除充分,但水超滤能力不足;标准儿童 PET 及其评价标准完全符合 Twardowski 标准 PET 要求。腹膜炎后溶质转运能力提高。
Objective To investigate the peritoneal transport characteristics of children with chronic peritoneal dialysis (PD) in our country through peritoneal balance test (PET). Methods Six children (2-14 years) undergoing continuous ambulatory peritoneal dialysis (cAPD) were included in this study. Ten children’s standard PET were evaluated for peritoneal solute transport by reference to the Twardowski and Pediatric Peritoneal Dialysis Alliance (PPDSC) criteria. Results The first PET in this group was performed on average (38.7 ± 15.6) days after the start of PD. The 4 h creatinine clearance (4 h-D / P) and 4 h glucose uptake (4 h-D / D 0) at 4 h were (0.85 ± 0.24) and (0.34 ± 0.19), respectively. According to Twardowski and PPDSC peritoneal transport type evaluation criteria, the peritoneal solute transport types in this group were 6 cases (6/10) of high transporter, 1 case (1/10) of high average transporter and 3 cases of low average transporter 10), no case of low transport type; the two standard classification of the total coincidence rate of 100%. This group of peritoneal glucose transport types were high transfer type in 3 cases (3/10), high average transfer type in 4 cases (4/10), low average transfer type in 1 case (1/10), low transfer type in 2 cases (2 / 10); The total coincidence rate of two standard typing 90%. Continuous PET showed different types of transporter, 4 h-D / P elevation after peritonitis. Conclusions The peritoneal solutes and glucose transport types of CAPD children in this study were mainly high transport and high average transport (7/10), showing a skewed distribution, suggesting that peritoneal dialysis solutes were sufficiently cleared in children with CAPD, but the water ultrafiltration capacity was inadequate. The standard PET And its evaluation criteria in full compliance with Twardowski standard PET requirements. Peritonitis after solute transport capacity increased.