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題名 | A Modified Fast Peritoneal Equilibration Test=改良型快速腹膜平衡測試 |
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作者姓名(中文) | 賴銘南; 劉玉賢; 楊得政; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷期 | 22:1 2008.03[民97.03] |
頁次 | 頁49-54+78 |
分類號 | 415.816 |
關鍵詞 | 腹膜平衡測試; 腹膜透析; Peritoneal equilibration test; Peritoneal dialysis; |
語文 | 英文(English) |
中文摘要 | 背景:腹膜平衡測試peritoneal equilibration test (PET)是評估腹膜通透性的好方法,但是傳統標準腹膜平衡測試standard PET (sPET)費時。而fast peritoneal equilibration test (fast PET)有其限制性及不甚正確,所以我們發展出新的改良型快速腹膜平衡測試modified fast PTE (mf PET)。方法:每位病人當天先進行sPET的第0小時透析液葡萄糖檢查。於第四小時,進行fast PET方法,留病人的第四小時腹膜透析液及血清。mfPET方法則是完成fast PET後,再請病人引流出全部的透析液並開始灌進新一袋(第二袋)2.5%的腹膜透析液,經快速翻身混合後,病人引流出透析液以測第0小時葡萄糖濃度(Dn),以和sPET的第0時透析了液(第一袋)葡萄糖(D0)比較。因此可以算出第4小時透析液與血清肌酸酐比值(D/P Cr)、第一袋第4小時與第0小時透析液葡萄糖比值(D4h/D0)、及D4h/Dn葡萄糖比值,並歸類腹膜平衡測試分級。結果:共有14位連續性腹膜透析病人(7男7女,年紀30至76歲)參加本研究。Dn與D0葡萄糖濃度有很好的相關性(r=0.846, P<0.001)。與D4h/D0葡萄糖比值的相關性,D4h/Dn葡萄糖比值(r=0.992, P<0.001)要比D4h葡萄糖濃度(r=0.975, P<0.001)更有相關性。在比較與sPET以D4h/D0葡萄糖比值及D/P Cr分級一致性方面,mfPET皆比fast PET更好(葡萄糖比值分級weighted kappa 0.92 vs. 0.80)(D/P Cr分級weighted kappa 0.65 vs. 0.45)。結論:改良型快速腹膜平衡測試確實比傳統標準腹膜平衡測試省錢省時,而且比快速腹膜平衡測試正確,所以可以作為標準腹膜平衡測試追蹤檢查時的良好取代方法。 |
英文摘要 | Background: The peritoneal equilibration test (PET) is a good tool for evaluating the permeability of the peritoneum. However, the standard PET (sPET) is time-consuming. Because of limitations and unreliability of the fast peritoneal equilibration test (fast PET), we evaluated the new modified fast PET (mfPET). Methods: All patients first underwent the sPET and the initial drain dialysate (D0) samples for glucose measurement were obtained. At the 4(superscript th) hour of the dwell dialysate, the fast PET was performed, and both serum and drain dialysate were obtained from the patients. The mfPET was also performed according to the following procedure. After the fast PET, the abdomen dialysate was completely drained and the abdomen was infused using a new bag of 2.5% dextrose dialysate. Soon after mixing was completed in the peritoneum, the dialysate was drained for sampling to measure the glucose level (D(subscript n)) at 0 hour for comparison with the initial drain dialysate (D0) glucose of the sPET. The dialysate-to-plasma ration for creatinine (D/P Cr) at the 4th hour, the drain dialysate at the 4(superscript th) hourlinitial dialysate (D(subscript 4h/D0) glucose ratio, and the D(subscript 4h)/D(subscript n) glucose ratio were calculated and fitted into the category of each PET. Results: Fourteen continuous ambulatory peritoneal dialysis patients (7 men and 7 women; age ranging from 30 to 76 years) participated in the study. The glucose levels of Dn were well correlated with those of Do (r=0.846, P<0.001). The correlation between the D(subscript 4h)/D(subscript n) glucose ratios and the D(subscript 4h)/D0 glucose ratios (r=0.992, P<0.001) was better than that between the D(subscript 4h) glucose levels and the D(subscript 4h)/D0 glucose ratios (r=0.975, P<0.001). With regard to agreement with sPET categories from the D(subscript 4h)/D0 glucose ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.92 vs. 0.80). With regard to agreement with the D/P Cr ratios, mfPET categories from the D(subscript 4h)/D(subscript n) glucose ratios were better than fast PET categories from the D(subscript 4h) glucose levels (weighted kappa, 0.65 vs. 0.45). Conclusions: The modified fast PET is more cost-effective than the standard PET and more reliable than the fast PET. Therefore, it can be used as a valid alternative procedure for follow-up of sPET. |
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