CAJ | 학술논문

目的探讨胸液水平( TFC)在肾病综合征患者血容量评估中的作用。方法将80例肾病综合征患者按照无创血流动力学监测仪监测的 TFC 分为非低血容量组( A 组：TFC≥21)、低血容量组(B组：TFC<21)。比较两组血电解质、尿电解质、血渗透压、尿渗透压、血尿素氮/血肌酐、血红蛋白、红细胞比容、血管紧张素玉、血管紧张素域、醛固酮及滤过钠排泄分数( FeNa)并进行相关性分析。结果两组患者血钾、血钠、血尿素氮/血肌酐、肾素、血管紧张素玉、血管紧张素域、血渗透压、尿渗透压水平比较，差异无统计学意义；A组白蛋白、血红蛋白、红细胞比容、醛固酮、血氯、血钙水平低于B组，差异有统计学意义( P<0.05)；A组24 h尿量、24 h尿钾、24 h尿钠、FeNa高于B组，差异有统计学意义(P<0.05)。 TFC与醛固酮、肾素、血管紧张素I、血管紧张素Ⅱ、血红蛋白呈负相关，差异有统计学意义( P <0.05)。FeNa与醛固酮、肾素、血管紧张素I、血管紧张素Ⅱ呈负相关，但差异无统计学意义。 TFC与FeNa呈正相关，差异有统计学意义( P<0.01)。结论TFC可用于评估肾病综合征患者血容量状态，需进一步研究验证其临床价值。
목적탐토흉액수평( TFC)재신병종합정환자혈용량평고중적작용。방법장80례신병종합정환자안조무창혈류동역학감측의감측적 TFC 분위비저혈용량조( A 조：TFC≥21)、저혈용량조(B조：TFC<21)。비교량조혈전해질、뇨전해질、혈삼투압、뇨삼투압、혈뇨소담/혈기항、혈홍단백、홍세포비용、혈관긴장소옥、혈관긴장소역、철고동급려과납배설분수( FeNa)병진행상관성분석。결과량조환자혈갑、혈납、혈뇨소담/혈기항、신소、혈관긴장소옥、혈관긴장소역、혈삼투압、뇨삼투압수평비교，차이무통계학의의；A조백단백、혈홍단백、홍세포비용、철고동、혈록、혈개수평저우B조，차이유통계학의의( P<0.05)；A조24 h뇨량、24 h뇨갑、24 h뇨납、FeNa고우B조，차이유통계학의의(P<0.05)。 TFC여철고동、신소、혈관긴장소I、혈관긴장소Ⅱ、혈홍단백정부상관，차이유통계학의의( P <0.05)。FeNa여철고동、신소、혈관긴장소I、혈관긴장소Ⅱ정부상관，단차이무통계학의의。 TFC여FeNa정정상관，차이유통계학의의( P<0.01)。결론TFC가용우평고신병종합정환자혈용량상태，수진일보연구험증기림상개치。
Objective To investigate the role of level of pleural fluid ( TFC ) in assessing the blood volume of the nephrotic syndrome. Methods 80 patients with nephrotic syndrome were divided into two groups in accordance with the level of pleural fluid (TFC) monitored by the noninvasive hemodynamic monitor:Group A:TFC≥21, re-presenting the non-low blood volume group;Group B:TFC<21, representing the hypovolemia group. Blood and u-rine electrolyte, blood and urine osmolality, blood sodium, blood urea nitrogen/creatinine, hemoglobin, hemato-crit, blood renin, angiotensin I, angiotensinII, aldosterone levels and filtrated fractional excretion of sodium ( Fe-Na) were compared between the two groups. Results Group A and group B in the level of serum potassium, blood sodium, blood urea nitrogen/creatinine, renin, angiotensin, angiotensin II, plasma osmotic pressure and urine os-molality had no significantly statistical difference; the level of blood albumin, hemoglobin, hematocrit, aldoste-rone, blood chloride and blood calcium in group A was lower than that in group B, and it was statistically signifi-cant (P<0. 05). The level of 24 h urine volume, 24 h urinary sodium, 24 h urinary potassium and FeNa in group A was higher than that in group B, there was statistically significant (P<0.05). TFC and aldosterone, renin, an-giotensin I, angiotensin II, Hb had a significant negative correlation (P<0.05). FeNa and aldosterone, renin, angiotensin I, angiotensin II had a negative correlation, but there was no significant difference. In addition, TFC and FeNa had a significant positive correlation ( P<0.01 ) . Conclusion The TFC can be used as a reference in-dex of blood volume assessment in patients with nephrotic syndrome, but it still needs clinical trials to further vali-date its value.