摘要
目的旨在分析不同HCO3^-浓度透析液对机体酸碱平衡以及营养状态的影响。方法24例稳定的维持性血液透析患者参与试验,使用单盲、交叉对照分析,共3个月试验周期,参试患者分别接受低HCO3^-浓度透析液(30.0mmol/L)(甲组)和高HCO3^-浓度透析液(40.0mmol/L)(乙组)透析,记录并分析人体生物学指标、生化指标和透析剂量以及透析充分性指标。结果试验开始时甲、乙组血清总CO2结合力分别为(22.0±2.6)mmol/L、(22.54±-3.2)mmol/L,两组比较差异无统计学意义;但乙组3个月后血清总CO2结合力增高到(25.5±1.8)mmol/L,与试验开始时比较差异有统计学意义;甲组无显著性变化。Kt/V(乙组1.29±0.21、甲组1.28±0.15),标准化蛋白代谢率(nPCR)[乙组(1.15±0.16)g/(kg·d)、甲组(1.25±0.18)g/(kg·d)]差异均无统计学意义。三角肌皮褶厚度(TSF)有显著性变化[甲组由试验开始时(14.8±1.6)mm,至3个月后(12.6±1.1)mm,乙组为(14.5±2.3)至(16.5±1.5)mm,P〈0.0530结论高HCO3^-浓度透析液对透析患者是相对安全的,患者均能较好耐受,且能较好地纠正机体酸中毒状态,与低HCO3^-浓度透析液相比,能提高患者TSF,提示患者营养状态改善。
Objective To investigate the effects of different bicarbonate dialysate on acid-base balance and nutritional status. Methods Twenty-four stable hemodialysis patients were dialysed using bicarbonate dialysate 30.0 mmol/L(group A) or 40.0 mmol/L(group B) in blind crossover trial, of 3-month periods. Anthropometric index,biochemical index,dialysis dose and sufficience index were measured. Results Combination rate of plasma total CO, was no difference between two groups [ (group A was (22.0 ± 2.6) mmol/L,group B was (22.5 ± 3.2)mmol/L] ,while 3 months later dialysis plasma total CO2 showed a significant change in group B [ (22.5 ± 3.2)mmol/L to (25.5 ± 1.8)mmol/L, P 〈 0.05 ]. Kt/V was 1.28 ± 0.15 in group A, 1.29 ± 0.21 in group B,nurmalized protein catabolic rate(nPCR) was( 1.25 ± 0.18)g/(kg·"d) and ( 1.15 ± 0.16) g/(kg·d) in two groups,there were no significant difference. Triceps skinfold thickness (TSF) was( 14.8 ± 1.6)-( 12.6 ± 1.1 )mm in group A, (14.5 ± 2.3)-(16.5 ± 1.5) mm in group B,there was a significant change (P 〈 0.05). Conclusions Bicarbonate dialysate concentration of 40 mmol/L is safe,well tolerated, and produces better control of acidosis, with an increase in TSF, compared to a bicarbonate concentration of 30 mmol/L.
出处
《中国医师进修杂志》
2007年第9期26-28,共3页
Chinese Journal of Postgraduates of Medicine