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目的:观察不同残余肾功能(RRF)对腹膜透析(PD)患者心血管系统的影响。方法:根据PD患者随访过程中残余肾小球滤过率(rGFR)水平将其分为A组(GFR0～2ml/min)、B组GFR(2.1～4ml/min)、C组GFR(4.1～6.0ml/min)和D组(>6.0ml/min)。每3个月对患者进行一次临床随访,全面评估患者的全身情况及透析状态,包括血浆白蛋白(Alb)、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、尿量(UV)、残余肾肌酐清除率(Ccr)、每周总尿素氮清除率(Kt/Vtotal)、每周肌酐总清除率(WCcrtotal)、蛋白氮呈现率(nPNA)、心脏超声和胸部平片。结果:四组不同RRF患者Kt/vtotal分别为1.66±0.42、1.85±0.40、2.11±0.45、2.60±0.69(P<0.01);四组间心胸比分别为0.54±0.08、0.51±0.07、0.51±0.06、0.50±0.06(P<0.05);左室后壁厚度分别为(10.4±1.79)、(9.96±1.35)、(9.51±1.33)、(9.65±1.40)mm(P<0.05);室间隔厚度分别为(10.9±1.88)、(10.4±1.59)、(10.2±1.59)、(10.1±1.47)mm(P<0.05);此外四组间Alb、SBP、DBP均存在统计学差异(P<0.05)。结论:RRF每下降2ml/min患者室间隔厚度、左室后壁厚度均增加,且室间隔厚度与RRF呈负相关。RRF对腹膜透析患者心血管并发症有重要影响。
Objective: To observe the effects of different residual renal function (RRF) on cardiovascular system in peritoneal dialysis (PD) patients. Methods: According to the residual glomerular filtration rate (rGFR) during the follow-up of PD patients, the patients were divided into group A (GFR0-2ml / min), group B GFR (2.1-4ml / min) 6.0 ml / min) and Group D (> 6.0 ml / min). Patients were followed up every 3 months to assess their overall condition and dialysis status, including Alb, SBP, DBP, BMI and urine output UV, Ccr, Kt / Vtotal, WCcrtotal, nPNA, echocardiography and chest radiograph. Results: The Kt / vtotal of four groups of RRF patients were 1.66 ± 0.42, 1.85 ± 0.40, 2.11 ± 0.45 and 2.60 ± 0.69, respectively (P <0.01). The cardiac thoracic ratios were 0.54 ± 0.08, 0.51 ± 0.07 and 0.51 ± 0.06,0.50 ± 0.06 (P <0.05). The thickness of posterior wall of left ventricle were (10.4 ± 1.79), (9.96 ± 1.35), (9.51 ± 1.33) and (9.65 ± 1.40) mm respectively The differences of Alb, SBP and DBP between the four groups were statistically significant (P <0.05). The thickness of the four groups were (10.9 ± 1.88), (10.4 ± 1.59), (10.2 ± 1.59) and (10.1 ± 1.47) mm 0.05). CONCLUSION: The thickness of interventricular septum and the thickness of posterior wall of left ventricle increase every 2 ml / min RRF, and the thickness of interventricular septum is negatively correlated with RRF. RRF has a major impact on cardiovascular complications in peritoneal dialysis patients.