- 期刊
Comparisons of Peritoneal Function between Diabetic and Nondiabetic Patients with End Stage Renal Disease
糖尿病與非糖尿病尿毒症病人腹膜功能之比較
摘要
腹膜功能是影響腹膜透析效果的最主要因素。糖尿病尿毒症病人由於大多有明顯的血管病變，是否腹膜微血管亦受波及而影響溶質平衡及水份清除是個值得探討的問題；因此我們對9名糖尿病及16名非糖尿病尿毒症病人，在實施連續性可擭帶式腹膜透析治療之前，分別以含1.5％及4.25 % Dextrose之透析液（Dianeal）灌入腹膜腔內，比較兩組病人之腹膜功能。9名糖尿病人包括6男3女，平均年齡58±13歲；而16名非糖尿病人包括7男9女，平均年齡41±12 歲。 結果：1．不論使用1.5％或4.25 % Dianeal，糖尿病人的水份超過濾量均偏低，但與非糖尿病人相比並未達統計學上有意義之差別。2.由透析液中吸收的葡萄糖量在兩組病人無明顯差別。3.幾種主要溶質之“透析液／血漿”濃度比值在兩組病人雖未呈有意義之差別，但就尿素氮及尿酸而言，其比值在糖尿病人有較高的傾向。4.以1.5 % Dianeal 在腹膜腔內滯留4小時後，小分子如尿素氮、肌酸酐、尿酸及磷的腹膜擴清率在糖尿病人有較高的傾向，但與非糖尿病人相比也未達統計學上有意義之差別。 以上結果得知，雖然糖尿病尿毒症病人的腹膜擴清率及水份超過濾量等與非糖尿病尿毒症病人稍有不同，但均未達統計學上有意義之差別，顯示糖尿病尿毒症病人的腹膜功能能並沒有特別的異常現象。
關鍵字
無資料並列摘要
Peritoneal function is the major determinant of the efficiency of peritoneal dialysis. To understand whether diabetes affects the peritoneal function, we performed the peritoneal clearance study in 9 diabetic. and 16 nondiabetic patients with end stage renal disease. The ultrafiltration volume tended to be lower in diabetics after infusion of 1.5% Dianeal, although there were no statistically significant differences between them. The same results were obtained after infusion of 4.25% Dianeal. The glucose uptake after infusion of both 1.5% and 4.25% Dianeal was not significantly different between the two groups. The dialysate/plasma(D/P) concentration ratio was also not significantly different between the two groups, however the D/P ratio for BUN and uric acid was slightly higher in the diabetic group. The peritoneal clearance of smaller molecules such as BUN, creatinine, uric acid and phosphate also tended to be higher in diabetics after infusion of 1.5% Dianeal for 4 hours. The peritoneal clearance became higher when more hyperosmotic dialysate were used in both diabetics and nondiabetics. The above results indicated that diabetic patients with end stage renal disease might have a normal peritoneal function compared to nondiabetics.
延伸閱讀
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