【摘要】目的 观察腹膜透析(peritoneal dialysis,PD)对慢性肾脏病基础上的急性肾损伤的疗效，并与间歇性血液透析(inermittent hemodialysis,IHD)进行比较。方法 回顾性分析上海交通大学附属第一人民医院2005年至2009年收治的共183例慢性肾脏病基础上的急性肾损伤患者，其中78例采用PD或IHD治疗：PD组(35例)：使用持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)、间歇性腹膜透析(intermittent peritoneal dialysis,IPD)或自动腹膜透析(automated peritoneal dialysis,APD)治疗；IHD组(45例)：采用IHD 1周3～4次治疗。观察一般资料(年龄、性别、原发病)，透析前和透析后连续血尿素氮、肌酐、钾的变化，预后(肾功能恢复和存活)，透析相关并发症。使用SPSS 10.0软件进行统计学分析，进行两组比较。结果 两组患者治疗前年龄、性别、原发病构成及疾病严重程度差异无统计学意义(P＞0.05)。PD组透析后连续血尿素氮、肌酐水平明显高于IHD组(P＜0.05)，而两组患者血钾、二氧化碳结合力等临床指标差异无统计学意义(P＞0.05)。随访显示，PD组肾功能恢复及存活与IHD组差异无统计学意义(P＞0.05)。PD组患者透析相关并发症发生率为11.4%，与IHD组(14.0%)相比差异无统计学意义(P＞0.05)。结论：PD治疗慢性肾脏病基础上的急性肾损伤效果与IHD基本相同，有利于患者肾脏功能的恢复，并且透析相关并发症发生率较低。
【Abstract】Objective The aim of this study was to investigate the effects of peritoneal dialysis (PD) and intermittent hemodialysis (IHD) in chronic kidney disease patients complicated with acute kidney injury. Methods We retrospectively reviewed 183 chronic kidney disease patients complicated with acute kidney injury, of whom 35 patients were treated with PD (PD group) and 45 patients with IHD (IHD group). Clinical data including age, sex, type of dialysis, underlying kidney disease, biochemistry indices and dialysis related complications were recorded. Results There were no differences in age, sex, underlying disease and severity of the disease before treatment between the 2 groups (P>0.05). After dialysis, serum creatinine and blood urea nitrogen were higher in PD group than in IHD group (P<0.05), but the survival rate and renal function recovery rate had no differences between the 2 groups. Dialysis related complications were found in 11.4% PD patients similar to the rate in IHD patients (14.0%, P>0.05). Conclusion PD may have the same effect as IHD in the improvement of kidney function in chronic kidney disease patients complicated with acute kidney injury.
