中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (01): 31-35.doi: 10.3969/j.issn.1671-4091.2016.01.008

• 临床研究 • 上一篇    下一篇

在线清除率监测评价维持性血液透析患者透析充分性的研究

杨冰1,甘良英1,蒋鹏志2,张启良3,王颖1,檀敏1,赵新菊1,王磊1,蔡美顺1,左力1,王梅1   

  1. 1. 北京大学人民医院肾内科
    2. 贵州省铜仁市人民医院干部二科
    3.河北省秦皇岛市卢龙县医院
  • 收稿日期:2015-11-26 修回日期:2015-12-18 出版日期:2016-01-12 发布日期:2016-05-19
  • 通讯作者: 甘良英 ganliangying@yahoo.com E-mail:yangbingqf@163.com
  • 基金资助:

    北京市科学技术委员会首都临床特色应用研究支持项目，项目编号：Z131107002213122 北京大学“临床医院合作专项”2013-1-05

The study of evaluation of dialysis adequacy by online clearance monitoring in hemodialysis patients with end- stage renal disease

  • Received:2015-11-26 Revised:2015-12-18 Online:2016-01-12 Published:2016-05-19

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摘要： 目的探讨在线清除率监测(online clearance monitoring，OCM)在评价维持性血液透析患者透析充分性中的应用价值。方法测定111 例稳定血液透析患者的在线清除率监测与取血法计算的单室尿素清除指数(spKt/V)。通过线性相关分析了解二者的相关性，并建立由OCM 推导spKt/V 的计算公式。通过多元线性回归分析得出影响在线清除率的相关临床因素。结果OCM 的Kt/V 值较取血法计算的Kt/V 值偏低，在线清除率监测Kt/V(1.22±0.20)，取血法计算的Kt/V(1.61±0.35)，t=15.182，P＜0.001。直线相关分析显示，二者具有良好的相关性(r=0.676，P＜0.001)，通过在线清除率监测可以推导出spKt/V 值。结论在线清除率监测值与取血法Kt/V 之间存在良好相关性，可应用在线清除率监测值估算取血法Kt/V 值，指导临床治疗。

关键词: 血液透析, 充分性, 在线清除率监测, 尿素清除指数

Abstract: Objectives To explore the relationship between the dialysis adequacy measured by online clearance monitoring (OCM)and Kt/V urea from pre- and post- dialysis blood samples, then establish formula to estimate Kt/V urea clearance by the online clearance monitoring, and analyze the clinical factors which affect the OCM. Methods OCM and Kt/V urea values from 111 maintenance hemodialysis patients were measured. The correlation between OCM and Kt/V urea values was analyzed by correlation assay. And formula to estimate Kt/V urea clearance by the online clearance monitoring was established. Clinical factors which affect
the value of Kt/V measured by OCM were analyzed by multiple linear regression. Results Dialysis dose measured by OCM was lower than Kt/V urea, correlating well with Kt/V urea (r=0.676, P＜0.001). Conclusions Dialysis dose measured by OCM goes hand in hand with Kt/V urea. The clinical factors that affect OCM include height, post-dialysis weight and body surface area.

Key words: Hemodialysis, Adequacy, Online clearance monitoring