中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (06): 411-414.doi: 10.3969/j.issn.1671-4091.2019.06.009

• 综述 • 上一篇    下一篇

生物电阻抗分析在维持性血液透析患者容量管理的应用现状

张周沧1,王梅2   

  1. 1. 北京大学国际医院肾内科部透析中心
    2. 北京大学人民医院肾内科
  • 收稿日期:2018-11-29 修回日期:2018-12-27 出版日期:2019-06-12 发布日期:2019-06-12
  • 通讯作者: 王梅wangmei1949@163.com E-mail:wangmei1949@163.com
  • 基金资助:

    北京大学国际医院院内科研基金(YN2017QN15)

Current situation of bioimpedance analysis for body hydration management in maintaining hemodialysis patients

  • Received:2018-11-29 Revised:2018-12-27 Online:2019-06-12 Published:2019-06-12

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摘要： 【摘要】容量超负荷使维持性血液透析(maitaining hemodialysis dialysis，MHD)患者心血管和全因死亡率增加，而容量不足可使低血压相关不良事件增加、残肾功能减退，甚至导致心脏顿抑。因此精准的容量管理对于MHD 患者的预后至关重要。通过临床评估患者容量状态，因其影响因素众多，故无法客观、准确评价容量状态。目前生物电阻抗分析(bioimpedance analysis，BIA)已成为临床最常用的客观评价血液透析患者容量状态的方法，具有精确、非侵入性、便捷、廉价等优势。本文就BIA 在MHD 患者容量和血压管理、对残肾功能以及长期预后如心血管、住院率、死亡率的影响做一综述。

关键词: 生物电阻抗分析, 容量状态, 血压, 长期预后, 维持性血液透析

Abstract: 【Abstract】Overhydration is closely related to cardiac mortality and all- cause mortality in maintaining hemodialysis (MHD) patients. On the other hand, hypohydration may lead to hypotension-associated adverse events, decrease of residual renal function and even cardiac stunning. Thus, accurate management of body hydration is essential to the outcome of MHD patients. Clinical observation cannot be used for the objective and accurate assessment of body hydration status in MHD patients due to the unwarranted interference of many factors. Bioimpedance analysis (BIA) is accurate, non- invasive, convenient and inexpensive, becoming the most useful method for objective assessment of body hydration status in MHD patients. In this review, we summarize BIA for the management of blood pressure and hydration status as well as the effects of BIA on residual kidney function and long-term outcomes such as cardiovascular complications, hospitalization rate and mortality.

Key words: bioimpedance analysis, body hydration status, blood pressure, long-term outcome, maintaining hemodialysis