【摘要】 目的 探索应用改良的节段生物电阻抗法-小腿电阻抗比值(CBIR)评估血液透析(HD)患者的容量状况。方法 使用多频生物电阻抗分析仪测定157例健康志愿者右侧小腿的电阻抗值，计算CBIR(impedance 200k/impedance 5k)作为容量负荷指标，并确定正常参考值范围。同时检测117例HD患者透析后CBIR，观察患者容量负荷状况。 结果 健康志愿者的CBIR为0.774±0.028，由此确定正常参考值范围为0.746～ 0.802(均数±1个标准差)。HD组透后CBIR明显高于正常对照组[(0.790±0.033) vs (0.774±0.028), P＜0.001]，其中容量增高者(CBIR＞0.802)、容量正常者(CBIR在 0.746～0.802)和容量降低者(CBIR＜0.746)分别占36.8%，53.0%，10.2%。在使用降压药的剂量无显著差异的情况下，CBIR增高组高血压的发生率明显高于CBIR正常组(P =0.008)和CBIR降低组(P =0.003)。 结论 小腿电阻抗检测可能是评估HD患者容量状况的有效方法。

【Abstract】 Objective To evaluate volume status in hemodialysis (HD) patients by modified bioimpedance spectroscopy - calf bioimpedance ratio (CBIR). Methods Calf bioimpedance was measured by bioimpedance spectroscopy. As an index of volume status, CBIR was calculated as follows: CBIR = impedance of 200 kHz / impedance of 5kHz. Reference CBIR range was obtained from 157 healthy volunteers. The volume status of 117 HD patients post-dialysis was assessed using the CBIR from healthy volunteers as the reference CBIR range. Results CBIR of the healthy volunteers was 0.774±0.028, the reference range was thus defined as 0.746～0.802 (mean±SD). CBIR was significantly higher in patients post-hemodialysis than in healthy volunteers（0.790±0.033 vs 0.774±0.028, P＜0.001). HD patients were divided into three groups according to the CBIR: high CBIR group (＞0.802), normal CBIR group (0.746 ~ 0.802), and low CBIR group (＜0.746). There were 43 patients in high CBIR group (36.8%), 62 patients in normal CBIR group (53.0%), and 12 patients in low CBIR group (10.2%). The doses of antihypertensive agents were not significantly different among the three groups. Nevertheless, hypertension was significantly higher in high CBIR group than in normal CBIR group (p=0.008) and low CBIR group (p=0.003). Conclusions Calf bioimpedance measurement may be an effective method for the evaluation of volume status in hemodialysis patients.