人体成分监测仪在血液透析患者干体重评估中的意义

Values of body composition monitor in evaluation of dry weight in hemodialysis patients

目的探索人体成分监测仪(body composition monitor,BCM)在血液透析患者干体重评估中的意义。方法选择在我院血液透析中心透析者126例作为研究对象,在我院体检中心健康体检的志愿者40例作为对照组,两组均行BCM监测,并记录总体液量(total body water,TBW)、细胞外液(extracellular water,ECW)、细胞内液(intracellular water,ICW)、水负荷(overhydration,OH)以及透析患者脱水量(即透析间期增长的体重),分析水负荷值与脱水量的关系以及水负荷值评估干体重的准确性,比较透析患者之间、透析患者与对照组之间体内水分分布的差异。结果水负荷值与脱水量呈正相关(r=0.462,P<0.01),水负荷值评估干体重ROC曲线下面积(AUC)为0.854;血液透析患者水钠潴留主要表现为细胞外液增多。下调血液透析患者干体重后其细胞外液明显下降,差异有统计学意义(P<0.05),且体内水分分布接近正常人。结论 BCM可客观的监测透析患者体内多余水分,对干体重的评估有一定意义。

Objective To study the value of the body composition monitor(BCM)in assessing the dry weight of hemodialysis patients. Methods 126hemodialysis(HD)patients were selected from the hemodialysis center of this hospital,and 40healthy volunteers selected as control group, using the BCM to analyze the human body composition.The measured value of the total body water(TBW),extracellular water(ECW),intracellular water(ICW),and overhydration(OH)were measured,and the dehydration of the HD patients calculated(extra weight acquired between hemodialysis).The relationship between the OH and the dehydration was analyzed,and the accuracy of the OH applied in the dry weight assessed.The difference of the moisture distribution was compared between dialysis patients,and between dialysis patients and normal people. Results OH and dehydration were positively correlated(r=0.462,P<0.01);for OH,the area under the ROC curve(AUC)was 0.854;water retention in hemodialysis patients mainly was ECW,which decreased obviously,with statistically significant difference(P<0.05).The moisture distribution was closer to normal people after lower the dry weight. Conclusion BCM can monitor the excess water in dialysis patients objectively,and can be used to assess the dry weight.