Kt/V值测定研究

Research about Kt/V

目的 探讨在实际临床应用中Kt/V值测定时应注意的问题 ;国人分别根据单室与双室模型所测定BUN及Kt/V值 (Kt/Vsp与Kt/Vsq)间的差异以及复用透析器对Kt/V值的影响。方法 18例规律透析的尿毒症患者共测定Kt/V值 42例次。观察比较Kt/Vsp(单室模型Kt/V)与Kt/Vsq(双室模型Kt/V)、BUNsp(单室模型BUN)与BUNsq(双室模型BUN)间的差别 ,以及不同复用次数透析器对Kt/V值的影响。结果 国人单室模型与双室模型的Kt/Vsp与Kt/Vsq间有显著性差异 (P <0 .0 0 1) ,前者均值较后者高 0 .14 5。BUNsq值是BUNsp值的 111.6%。透析器分别复用 1～ 2次组与未复用透析器组相比其Kt/V值无显著性差别 (P >0 .0 5)。结论 Kt/Vsp与Kt/Vsq间有显著性差异 ,但较国外报道的差异小(0 .14 5对 0 .2 0 0 )。BUNsq与BUNsp的差异也较国外明显为低 (111.6%对 170 .0 % )。复用透析器 1～ 2次对Kt/V值无明显影响。每周透析两次需要较每周透析

Objective To find out the key aspect that is important for measuring Kt/Vcorrectly,The difference of Chinese between BUNsp vs BUNsq and Kt/Vsp vs. Kt/Vsq; The effect of reusing dialyser on Kt/V Methods Eighteen routine hemodialysis patients were measured Kt/V for 42 times. Compare Kt/V sp(single-pool Kt/V) vs Kt/Vsq (equilibrated Kt/V), BUNsp(BUN concentration at the end of hemodialysis) vs BUNsq(equilibrated post-dialysis BUN concentration),and the Kt/V among different dialyser reusing time groups.Result There was significant difference between Kt/Vsp and Kt/Vsq(P<0.001),the difference of their average value is 0.145 BUNsq is 111.6% higher than BUNsp.There was no significant difference of Kt/V among different dialyser reusing time groups(P>0.05). Conclusion The difference between Kt/Vsp and Kt/Vsq is significant, but the difference is smaller than the result from overseas (0.145 vs. 0.200), The difference between BUNsp and BUNsq is much lower than overseas result (111.6 vs. 170.0). There is no significant difference among different reusing time dialyser groups (less than 2 times). Higher Kt/V is need for twice-weekly hemodialysis patient than thrice-weekly hemodialysis one.