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腹膜平衡试验

Authors
Madhukar Misra, MD, FRCP
Ramesh Khanna, MD, FACP
Section Editor
Thomas A Golper, MD
Deputy Editor
Alice M Sheridan, MD
Translators
宋锴, 副主任医师，副教授

引言

腹膜平衡试验(peritoneal equilibration test, PET)是一种在腹膜透析患者中用于评估腹膜转运功能的半定量检测方法[1,2]。其原理是通过测定溶质在腹膜毛细血管血液与透析液间达到平衡的速率，对腹膜的溶质转运率进行评估。在腹透液留在腹腔内的特定时间点(t)，溶质在透析液与血浆中的浓度比(D/P比)可反映溶质转运平衡的程度。该比可根据任何一种溶质从毛细管血管血液转运至透析液的情况确定，其中肌酐、尿素、电解质、磷酸盐和蛋白质是临床中经常检测的溶质。

由于透析液中的葡萄糖会被吸收入血液并被快速代谢，其传统的D/P比没有意义。然而，通过特定时间点透析液中葡萄糖的浓度与透析液中葡萄糖初始浓度的比(Dt/D0)，可确定该时间点透析液中葡萄糖的吸收分数。另外，PET也有助于测量超滤量和残余量[3,4]。

腹膜平衡试验的概述将总结在此。对于清除或超滤充分性欠佳的患者的评估，有关PET效用的详细分析见其他专题。 (参见“连续腹膜透析中溶质清除和超滤问题的探讨”)

腹膜平衡试验的元素

PET是一种重复性很高的试验，其标准流程是使用透析液进行4小时的透析交换[5]。试验结果可用于比较一例长期腹透患者的多次透析结果；此外，其也可用于在同一透析中心的不同患者或不同地区的不同人群中进行比较。

PET试验需将如下元素标准化[3]：

           

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Literature review current through: 2017-06 . | This topic last updated: 2015-09-04.
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