中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (07): 425-42.doi: 10.3969/j.issn.1671-4091.2015.07.011

• 临床研究 • 上一篇    下一篇

应用生物电阻抗分析维持性血液透析患者体液分布特点

张磊1,2,李新伦2,李红霞2,郑秀瑗3,唐智莉3,伦立德1,2   

  1. 230032 合肥，1 安徽医科大学空军临床学院
    100142 北京，2 解放军空军总医院肾病科
    100084 北京，3 清华大学体育部
  • 收稿日期:2015-04-24 修回日期:2015-05-20 出版日期:2015-07-12 发布日期:2015-07-12
  • 通讯作者: 伦立德 15611161117@163.com E-mail:lunlideldm@163.com

The characteristics of body fluid distribution in maintenance hemodialysis patients by using bioelectrical impedance

  • Received:2015-04-24 Revised:2015-05-20 Online:2015-07-12 Published:2015-07-12

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摘要： 【摘要】目的应用多频生物电阻抗分析法研究维持性血液透析(MHD)患者透析前后体液分布特点。方法选取临床干体质量达标的MHD 患者86 例，并选取同质的健康人群258 例作为对照组，运用多频人体成分分析仪测量透析前后体质量(W)、身体总水(TBW)、细胞内液(ICW)、细胞外液(ECW)，计算透析前后ICW/W、ICW/TBW、ICW/H2、ECW/W、ECW/TBW、ECW/H2 以及ICW/ECW。结果MHD 患者透析前ECW/H2 明显高于对照组[男(4.77±0.58 vs. 4.52± 0.36)，P＜0.01；女(4.16±0.47 vs. 3.97±0.32)，P＜0.01]，透后接近对照组透析前后ICW/TBW，ICW/ECW 及ECW/TBW 之间，以及与对照组比较均无明显差别。ICW/H2 表现不完全一致，男性患者透析前ICW/H2 高于对照组[男(9.42±1.26 vs. 9.03±0.75，(P＜0.05)]，透后接近对照组[男(8.83±1.15 vs. 9.03±0.75，(P＞0.05)]，女性患者透析前明显高于透后[女(8.07±0.79 vs. 7.52±1.49，P＜0.05]。结论①维持性血液透析患者体内潴留的水分并非主要分布于细胞外液，而是同时分布于细胞内液和细胞外液；透析超滤脱水不仅影细胞外液，同时影响细胞内液。② ECW/H2 和ICW/H2 透析后明显下降，接近正常人，有可能成为评价维持性血液透析患者水负荷状态的一个指标，需要进一步研究。

关键词: 生物电阻抗, 血液透析, 体液分布, 细胞内液, 细胞外液

Abstract: 【Abstract】Objective of this study was to study the characteristics of fluid distribution by using multifrequency bioelectrical impedance in maintenance hemodialysis (MHD) patients before and after dialysis. Methods A total of 86 MHD patients who reached the target of clinical dry weight were selected as the experiment group. Meanwhile, a total of 258 healthy cases were recruited as the control group. Body weight (W), total body water (TBW), intracellular water (ICW) and extracellular water (ECW) before and after a dialysis session were measured by using a multi-frequency body composition analyzer. ICW/W, ICW/TBW, ICW/ H2, ECW/W, ECW/TBW, ECW/H2 and ICW/ECW before and after a dialysis session were then calculated. Results Before dialysis, ECW/H2 was significantly higher in experiment group than in control group (4.77± 0.58 vs. 4.52±0.36 in males, P＜0.01; 4.16±0.47 vs. 3.97±0.32 in females, P＜0.01). After dialysis in experiment group, ECW/H2 approximated to that of control group. Before and after a dialysis session in experiment group, there were no significant differences in ICW/TBW, ICW/ECW and ECW/TBW. Between experiment group and control group. For ICW/H2 in males, the level in experiment group before dialysis was higher than that in control group (9.42±1.26 vs. 9.03±0.75, P＜0.05), and the level after dialysis approximated to that of control group (8.83±1.15 vs. 9.03±0.75, P＞0.05). For ICW/H2 in females, the level before dialysis was significantly higher than that after dialysis (8.07±0.79 vs. 7.52±1.49, P＜0.05). Conclusion ①In MHD patients, water was retained not mainly in extracellular space but in both extracellular and intracellular spaces. Dialysis by ultrafiltration decreased the water retention in both extracellular and intracellular spaces. ②ECW/ H2 and ICW/H2 decreased closely to those of normal persons after dialysis. Therefore, ECW/H2 and ICW/H2 may represent water load status in MHD patients, and need to be further studied.

Key words: Bioelectrical impedance, Hemodialysis, Body fluid distribution, Intracellular water, Extracellular water