【摘要】目的探讨国人固有型腹膜高转运患者的临床特点，并观察晚期糖基化终末产物受体(RAGE)基因单核苷酸多态性对腹膜转运特性的影响。方法回顾性总结194 例腹膜透析患者的临床资料，按照透析开始后的腹膜转运特性分为低转运组(21 例)、低平均转运组(55 例)、高平均转运组(93 例)、高转运组(25 例)4 组，比较患者人口学资料、透析前生化指标以及RAGE 基因型；应用logistic 回归分析患者腹膜高转运的独立危险因素。结果4 组患者在性别分布、心血管并发症、C 反应蛋白水平存在显著差异(P＜0.05)；RAGE 基因多态性除-374T/A 位点外，其余位点多态性分布均无显著差异(P＞0.05)。回归分析显示，C 反应蛋白、心血管并发症以及RAGE 基因-374T/A 多态性是患者腹膜高转运的独立危险因素。结论腹膜透析患者透析前C 反应蛋白、心血管并发症史以及RAGE 基因-374T/A 多态性可能与国人腹膜高转运有关，他们可为临床提前预判患者的腹膜转运状态提供参考。

【Abstract】Objective To investigate the clinical characteristics and single nucleotide polymorphisms of the receptor for advanced glycation end product (RAGE) in peritoneal dialysis (PD) patients with intrinsically high peritoneal transport rate in the peritoneum. Methods During the period from January 2011 to June 2014, 194 newly started PD patients were included in this study. Patients were divided into four groups: low (L), low average (LA), high average (HA), and high (H) peritoneal transport rate groups, according to their categories of peritoneal transport rate defined by the result of peritoneal equilibration test (PET) at 8-12 weeks after PD. The clinical data and RAGE genotypes were compared across the groups. Multiple logistic regression analysis (backward stepwise) was used to determine the independent factors associated with high peritoneal transport rate. Results Significant difference in gender, history of cardiovascular complications, and serum C-reaction protein level were found among the groups (P＜0.05). Among the four most common polymorphisms in RAGE gene, only -374T/A polymorphism was found to be associated with the peritoneal transport status. RAGE -374TA/AA genotype had a significantly lower prevalence in patients with H/HA transport status than did -374T/T genotype (P＜0.05). Logistic regression analysis showed that the history of cardiovascular complications, serum C-reaction protein level, and RAGE -374T/A polymorphism were the independent risk factors for high peritoneal transport rate (P＜0.05). Conclusion The history of cardiovascular complications, higher serum C-reaction protein level, and RAGE -374T/A polymorphism may be useful markers in predicting
the high peritoneal transport rate before PD.