中国血液净化

›› 2003, Vol. 2 ›› Issue (1): 20-22.

• 论著 • 上一篇    下一篇

在线尿素清除率监测及其临床意义

余 毅 袁伟杰 于 光 张国兆   

  1. 350025 福州，南京军区福州总医院血液透析中心(余 毅）；200433 上海，上海长海医院血液透析中心（袁伟杰，于 光，张国兆）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-01-19 发布日期:2003-01-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2003-01-19 Published:2003-01-19

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摘要： 【摘要】目的 探讨在线尿素清除率监测（OCM）的临床应用价值及在透析充分性评价中的临床意义。方法 采用4008S血液透析机OCM 检测了38例维持性透析患者一次血液透析时的尿素清除指数（Kt／V值），并用尿素动力一室模型计算Kt／V值；根据有、无残余肾功能，将38例分为两组对OCM和计算Kt／V值进行比较。结果 38例患者OCM检测Kt／V值为1.13±0.58，计算Kt／V值为1.18±0.17， 具有良好的相关性（r=0.887，P＜0.01）。尿素动力模型计算二组的Kt／V值有显著差异（P＜0.05），而OCM检测其 Kt／V值则无显著差异（P＞0.05）。结论 血液透析机OCM可作为检测Kt／V，评价透析充分性的简便、可靠的指标，并可避免透析后尿素反弹和残余肾功能的影响。

关键词: 在线尿素清除率, 透析充分性, 尿素动力模型

Abstract:

【Abstract】Objective To evaluate the clinical efficiency of online clearance measurement (OCM) based on conductivity variation. Methods Kt／V were assessed both by OCM and urea kinetic model in 38 maintenance hemodialysis patients, of which 2 groups were separated according to their residual renal function. Results Kt／V as estimated by OCM were 1.13±0.58, whereas measurements of Kt／V were 1.18±0.17 by urea kinetic model. They showed highly significant linear correlation(r=0.887，P＜0.01). Measurements of Kt／V by urea kinetic model had significant differences between 2 groups（P＜0.05), while Kt／V as estimated by OCM had no significant differences（P＞0.05）. Conclusion The OCM option of the hemodialysis machine provides an accurate tool for online monitoring of urea clearance to evaluate dialysis adequacy. 

Key words: Dialysis adequacy, Urea kinetic model