摘要
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 explore the characteristics of peritoneal transport in children undergoing chronic peritoneal dialysis （PD）. Methods Peritoneal equilibration test （PET） was carried out 10 times in 6 children （aged from 2 to 14 years） who were maintained by continuous ambulatory peritoneal dialysis （CAPD）, and the peritoneal solution transport rate was evaluated by the standards of Twardowski＇s and Pediatric Peritoneal Dialysis Study Consortium （PPDSC）＇s criteria. Results In this study, the initial PET was performed at （38. 7 ± 15.6） days following initiation of PD, the 4-hours of peritoneal creatinine clearance （4 h-D/P） and glucose absorption （4 h-D/D0） was （0.85 ±0.24） and （0.34 ±0. 19）, respectively. According to the standards of Twardowski＇s and PPDSC criteria, the peritoneal transport categories were divided into high transport （H）（6/10）, high average transport （HA） （1/10）, low average （LA） （3/10） for peritoneal solution transport, and H（3/10）, HA（4/10）, LA（1/10）, low transport （2/ 10） for glucose absorption. No low transport type of solution was used in the patients. The coincidence rate of peritoneal creatinine and glucose transport types were 100% and 90% between the Twardowski＇s and PPDSC criteria, respectively. The different changes of peritoneal transport type were found in two patients with continuous PET. The value of 4 h-D/P increased after peritonitis episodes. Conclusion The results showed that the PET in 70% of CAPD children fell into high and high average transport categories elevated by PPDSC＇s and adult standards, no-sinusoid distribution. The peritoneal solute clearance was adequate in the children, but net water ultrafiltration was lower. Standard pediatric PET and its criteria are consistent with the adult criteria. The capability of peritoneal solute transport increased after peritonitis episodes.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2007年第3期189-193,共5页
Chinese Journal of Pediatrics
关键词
腹膜透析
持续不卧床
儿童
腹膜
生物转运
Peritoneal dialysis, continuous ambulatory
Child
Peritoneum
Biological transport
