不同体重指数腹膜透析患者的预后分析

Prognosis analysis of peritoneal dialysis patients with different body mass indexes

摘要:

目的 探讨不同体重指数（BMI）腹膜透析（PD）患者的预后情况。方法 选取2011 年7 月- 2016 年12 月于成都医学院第一附属医院开始行持续非卧床腹膜透析（CAPD）治疗患者，按BMI 分为低体 重组（<20 kg/m2），正常组（≥ 20 kg/m2 ～ <25 kg/m2）及超重组（≥ 25 kg/m2），分析3 组患者的生存情 况及腹膜透析相关性腹膜炎发生率，分析患者BMI 与临床指标的相关性，并对不同临床指标进行比较分析。 结果 3 组患者生存率比较有差异（P <0.05），3 组患者腹膜炎发生率比较有差异（P <0.05）,BMI 与24 h 尿量、 TG、GLU 及总尿素清除率呈正相关（P <0.05），与腹膜尿素清除指数呈负相关（P <0.05）。3 组患者24 h 尿量、 总体水、腹膜尿素清除指数、总尿素清除率及TG 比较有差异（P <0.05）。结论 不同BMI 的PD 患者具有 不同的预后，众多临床因素的参与导致了超重及低体重均不利于患者的长期生存，应将PD 患者的BMI 控制 在适当范围内。

Abstract:

Objective To investigate the prognosis of peritoneal dialysis (PD) patients with different body mass index (BMI), analyze the relationships between BMI and clinical indicators, and compare the differences in clinical indicators of the PD patients with different body mass index. Methods A total of 107 cases receiving continuous ambulatory peritoneal dialysis in the First Affiliated Hospital of Chengdu Medical College between July 2011 and December 2016 were retrospectively analyzed. Those patients were classified as underweight group (BMI <20 kg/m2), normal weight group (20 kg/m2 ≤ BMI <25 kg/m2), and overweight group (BMI ≥ 25 kg/m2). The survival status and the incidence of peritoneal dialysis-related peritonitis were analyzed in different groups. The clinical indicators were collected, the relationships between those indicators and BMI were analyzed. Finally, the clinical indicators in different groups were compared. Results The survival rate was significantly different among the three groups (P < 0.05), the highest survival rate was in the normal weight group. The peritonitis incidence was different among the three groups (P < 0.05). According to Pearson correlation analysis, BMI was positively correlated with GLU, 24-h urine, triglycerides (TG) and total urea clearance rate (P < 0.05), but negatively correlated with peritoneal urea clearance index (KpT/V) (P < 0.05). There were differences in 24-h urine volume, total water, KpT/ V, total urea clearance rate, and TG among the three groups (P < 0.05). Conclusions The patients with different BMI have different prognosis. The participation of many clinical factors leads to different outcomes. Survival rate is decreased in both underweight and overweight patients, thus the BMI in PD patients should be controlled in an appropriate range.