CAJ | 학술논문

目的：研究人体成分监测仪（BCM）在血液透析患者干体重评估中的意义。方法选择126例在我院血液透析中心透析的患者作为病例组，选择40例在我院体检中心体检健康的志愿者作为对照组，两组分别行BCM监测。记录测得的总体液量（TBW）、细胞外液（ECW）、细胞内液（ICW）、水负荷（OH），记录患者透析脱水量、上机前血压以及对照组血压。利用ROC曲线分析OH值评估干体重的准确性，Logistic回归分析影响OH值的因素。结果（1）OH值与脱水量呈正相关（r＝0.462，P＜0.001）。（2）OH值评估干体重ROC曲线下面积（AUC）为0.877，当取3.30 L临界值时，灵敏度为0.909，特异性为0.833。（3）ECW、SBP是影响OH值的关键因素（P＜0.05），且影响程度ECW＞SBP。结论 BCM可客观地监测透析患者体内多余水分，对干体重的评估有一定的意义。
목적：연구인체성분감측의（BCM）재혈액투석환자간체중평고중적의의。방법선택126례재아원혈액투석중심투석적환자작위병례조，선택40례재아원체검중심체검건강적지원자작위대조조，량조분별행BCM감측。기록측득적총체액량（TBW）、세포외액（ECW）、세포내액（ICW）、수부하（OH），기록환자투석탈수량、상궤전혈압이급대조조혈압。이용ROC곡선분석OH치평고간체중적준학성，Logistic회귀분석영향OH치적인소。결과（1）OH치여탈수량정정상관（r＝0.462，P＜0.001）。（2）OH치평고간체중ROC곡선하면적（AUC）위0.877，당취3.30 L림계치시，령민도위0.909，특이성위0.833。（3）ECW、SBP시영향OH치적관건인소（P＜0.05），차영향정도ECW＞SBP。결론 BCM가객관지감측투석환자체내다여수분，대간체중적평고유일정적의의。
Objective To study the clinical significance of the body composition monitor (BCM) in evaluating the dry weight of hemodialysis patients. Methods One hundred and twenty six hemodialysis patients were selected as the case group. 40 healthy volunteers were used as the control group. These two groups were analyzed by the BCM, respectively. The amount of the total body water (TBW), extracellular water (ECW), intracellular water (ICW), over hydration (OH) were measured and recorded. The blood pressure of hemodialysis patients and control group was measured before the BCM analyses. ROC curve was used to analyze the OH value for assessing the accuracy of dry weight, while the factors to affect the OH value were analyzed by Logistic regression. Results (1)OH value was positively correlated with the amount of dehydration (r=0.462, P<0.001). (2) The area under the ROC curve was 0.877, when the cut-off point was at 3.30 L, the sensitivity of evaluation was 0.909, while the specificity of evaluation was 0.833. 3) Logistic regression analyses showed that ECW and SBP were the key factor to affect the OH value (P<0.05), where the ECW contributed more than that of SBP. Conclusion BCM can objectively monitor the amount of extra water in hemodialysis patients, and play an important role in evaluating the dry weight.