中国血液净化

›› 2010, Vol. 9 ›› Issue (12): 654-657.doi: 10.3969/j.issn.1671-4091.2010..00

• 临床研究 • 上一篇    下一篇

联合应用生物电阻抗及在线血容量监测评估血液透析患者干体质量的研究

张俊霞 徐金升 崔立文 张慧然 何 雷   

  1. 河北医科大学第四医院肾内科
  • 收稿日期:2010-05-25 修回日期:1900-01-01 出版日期:2010-12-12 发布日期:2010-12-12
  • 通讯作者: 徐金升

Combined bioelectrical impedance and on-line blood volume monitoring on evaluating the dry weight in dialysis patients

ZHANG Jun-xia, XU Jin-sheng, CUI Li-wen, ZHANG Hui-ran, HE lei   

  1. Department of Nephrology, the Forth Hospital of Hebei Medical University, Shijiazhuang 050011, China
  • Received:2010-05-25 Revised:1900-01-01 Online:2010-12-12 Published:2010-12-12

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摘要： 目的 联合应用生物电阻抗分析和在线血容量监测评估血液透析患者干体质量。 方法 对照组：240例石家庄市区健康志愿者。病例组：40例临床法评估均达到干体质量的维持性血液透析的患者，根据生物电阻抗分析法分为达干体质量亚组(8例)和未达干体质量亚组(32例)。应用Maltron BioScan 916生物电阻抗仪测定对照组和病例组的体内水含量及分布[总体水含量占体质量的百分比(TBW%)、细胞外液占总体水含量的百分比(ECW/TBW%)、细胞内液占总体水含量的百分比(ICW/TBW%)]。使用Fresenius 4008s BVM系统监测病例组初入组时未达干体质量亚组下调直至生物电阻抗法评估达干体质量后相对血容量的变化(ΔBV%)。 结果 未达干体质量亚组TBW%、ECW/TBW%、ICW/TBW%均与对照组差异有统计学意义(P＜0.05)，但缓慢下调干体质量后与对照组比较差异无统计学意义(P＞0.05)。未达干体质量亚组调整干体质量前后分别与达干体质量亚组比较，△BV%差异无统计学意义(P＞0.05)。 结论 生物电阻抗分析法较临床评估法更准确评价透析患者的干体质量。联合应用生物电阻抗和在线血容量监测△BV%可以安全、准确地评估透析患者的干体质量。

关键词: 生物电阻抗, 在线血容量监测, 总体水含量, 血液透析, 干体质量

Abstract: Objective To estimate the dry weight in hemodialysis patients by the combination of bioelectrical impedance analysis and on-line blood volume monitoring. Methods We observed 40 hemodialysis patients who reached the dry body weight by clinical evaluation method, and divided them into dry weight reached group (8 cases) and dry weight not reached group (32 cases) based on the results of bioelectrical impedance analysis. We also observed 240 healthy volunteers as the control group. TBW% (percent of total body water), ECW/TBW% (ratio of extracellular water to total body water) and ICW/TBW% (ratio of intracellular water to total body water) were measured by Maltron BioScan 916 instrument. Changes of blood volume (△BV%) in patients in dry weight not reached group at first and then moved to dry weight reached group were evaluated by using Fresenius 4008s BVM system. Results TBW%, ECW/TBW% and ICW/TBW% were statistically different between the dry weight not reached group and control group (P<0.05), but became statistically indifferent between the patients moved from dry weight not reached group to dry weight reached group and control group (P>0.05). △BV% had no statistical difference (P>0.05) in the patients before and after moved from dry weight not reached group to dry weight reached group compared respectively to the patients in dry weight reached group. Conclusion Bioelectrical impedance analysis is more accurate than clinical assessment in evaluating the dry weight. △BV% estimation using bioelectrical impedance analysis combined with on-line blood volume monitoring is a safe and accurate method for dry weight assessment in dialysis patients.

Key words: On-line blood volume monitoring, Total body water, Hemodialysis