中国血液净化

›› 2010, Vol. 9 ›› Issue (2): 84-87.

• 临床研究 • 上一篇    下一篇

探索应用节段生物电阻抗法评价血液透析患者容量状况

刘 婧 周亦伦 孙 芳 马丽洁 沈 洋 韩 彬 刘文虎 崔太根   

  1. 首都医科大学附属北京朝阳医院肾内科,首都医科大学附属北京友谊医院肾内科
  • 收稿日期:2009-10-13 修回日期:1900-01-01 出版日期:2010-02-12 发布日期:2010-02-12
  • 通讯作者: 崔太根,刘文虎

Application of modified segmental bioimpedance spectroscopy for estimation of volume status in hemodialysis patients

LIU Jing1, ZHOU Yi-1un1, SUN Fang1, MA Li-jie1, SHEN Yang1, HAN Bin1, LIU Wen-hu2, CUI Tai-gen   

  1. 1Department of Nephrology, Beijing Chaoyang Hospital, Capital Medical University; 2Department of Nephrology, Beijing Friendship Hospital, Capital Medical University
  • Received:2009-10-13 Revised:1900-01-01 Online:2010-02-12 Published:2010-02-12

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摘要：

【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。

关键词: 生物电阻抗, 血液透析, 容量状况

Abstract:

【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.

Key words: Bioimpedance, Volume status