生物电阻抗法对血液透析患者干体重的评估作用研究

Research of values of bioelectrical impedance analysis in hemodialysis patients dry weight assessment

目的探讨生物电阻抗法评估血液透析患者透析前后体液分布特点和干体重的价值。方法选择~2014年1月至~2016年7月在本院血液维持中心行血液透析的58例患者为研究对象(观察组),并选择同期健康志愿者70例作为对照组,测定血液透析患者(MHD)患者透析前后身高(H)、体重(W)、细胞内液体积(ICV)、细胞外液体积(ECV)、血红蛋白(Hb)、白蛋白(Alb)等指标,对比两组体成分指标差异和观察组透析前后ECV、ICV、ECV/ICV、ICV/H^2、ECV/H^2、ICV/W、ECV/W等指标的变化,分析ECV/ICV比值与心胸比(CTR)、尿素清除分数(Kt/V)、Hb、Alb的相关性。结果透析前观察组男性和女性患者的ECV%、ECV/ICV值与对照组比较差异均有显著性(P<0.05)。观察组血液透析后ECV、ICV、ICV/H^2、ECV/H^2、ICV/W、ECV/W均明显下降,与透析前比较差异有显著性(P<0.05);透析后ECV/ICV比值与CTR呈显著负相关(r=-0.634,P=0.00),与Kt/V、Alb、Hb无明显相关性(P>0.05)。结论生物电阻抗法检测ICV、ECV可用于血液透析患者干体重的预测、评估及调整。

Objective To investigate the distribution of body fluids assessment before and after hemodialysis and hemodialysis patients in the adjustment of the dry weight using bioelectrical impedance analysis. Method From January 2014 to July 2016 in our hospital blood centers maintain hemodialysis patients,58 healthy volunteers over the same period 70 cases as the control group for the study （study group）, and is measured in hemodialysis patients （MHD） before and after dialysis patient height （H）, body weight （W）, the intmcellular fluid volume （ICV）, extmcellular fluid volume 0ECV）, hemoglobin （Hb）, albumin （Alb） and other indicators, comparing body composition indexes between the two groups and changes in the observation group before and after the dialysis itself ECV, ICV, ECV/ICV, ICV/H~, ECV/H2, ICVAV, ECVAV and other indicators, analyzes ECV/ICV ratio cardiothoraeic ratio （CTR）, dialysis adequacy （Kt/V）, I/b, Alb correlation. Result The observation group predialysis male and female ECV%, ECV/ICV compared with the control group, the differences were statistically significant （P〈0.05）; after hemodialysis ECV, ICV, ICV/H2, ECV/H2, ICVAV, ECVAV were significantly decreased, with statistical significance （P〈0.05） than those before dialysis; dialysis ECV/ICV ratio and CTR was a significant negative correlation （P〈0.05）, and Kt/V, Alb negatively correlation between Hb and positively correlated, but the correlation was not statistically significant （P〉0.05）. Conclusion Bioelectrical impedance detection ICV, ECV and other indicators can help to predict the dry weight of hemodialysis patients and to evaluate and adjust the dry body weight is significant.