CAJ | 학술논문

目的：观察维持性血液透析患者透析前后β羟丁酸浓度变化，并进一步分析可能的影响因素。方法选取31例维持性血透患者，共完成检测62例次透析前后β羟丁酸浓度，并与22例健康人空腹所测值进行比较。同时将血透组患者透析前后β羟丁酸浓度变化值与对应患者的年龄、性别、甘油三酯水平、胆固醇水平、BMI指数、白蛋白、透析脱水量/干体重比值、透析前后血糖差值、透析前后血肌酐差值、整体尿素清除率（KT/V）、尿素下降率（URR）进行pearson相关分析和多元线性回归分析。结果血透组透析后血浆β羟丁酸浓度平均值高于透析前平均值（P<0.05），两者均高于对照组（P<0.05）；pearson相关分析示透析前后β羟丁酸浓度差值与白蛋白（R=-0.441）、血红蛋白（R=-0.366）、透析前后血肌酐差值（R=0.288）、胆固醇值（R=-0.292）相关。多元线性回归分析显示透析前后血肌酐差值、血清白蛋白、原发病和年龄是血透患者透析前后β羟丁酸浓度变化的独立影响因素。结论维持性血透患者体内β羟丁酸浓度高于正常人水平，透析可致血浆β羟丁酸水平进一步升高，且升高程度受年龄、原发病、血白蛋白、透析前后血肌酐差值的影响。
목적：관찰유지성혈액투석환자투석전후β간정산농도변화，병진일보분석가능적영향인소。방법선취31례유지성혈투환자，공완성검측62례차투석전후β간정산농도，병여22례건강인공복소측치진행비교。동시장혈투조환자투석전후β간정산농도변화치여대응환자적년령、성별、감유삼지수평、담고순수평、BMI지수、백단백、투석탈수량/간체중비치、투석전후혈당차치、투석전후혈기항차치、정체뇨소청제솔（KT/V）、뇨소하강솔（URR）진행pearson상관분석화다원선성회귀분석。결과혈투조투석후혈장β간정산농도평균치고우투석전평균치（P<0.05），량자균고우대조조（P<0.05）；pearson상관분석시투석전후β간정산농도차치여백단백（R=-0.441）、혈홍단백（R=-0.366）、투석전후혈기항차치（R=0.288）、담고순치（R=-0.292）상관。다원선성회귀분석현시투석전후혈기항차치、혈청백단백、원발병화년령시혈투환자투석전후β간정산농도변화적독립영향인소。결론유지성혈투환자체내β간정산농도고우정상인수평，투석가치혈장β간정산수평진일보승고，차승고정도수년령、원발병、혈백단백、투석전후혈기항차치적영향。
Objective To observe the concentration change of β-hydroxybutyric acid before and after dialysis of maintenance Hemodialysis patients and analyzing further the possible effective factors.Method we selected 31 maintenance Hemodialysis patients,completed in all 62 detections in the concentration change ofβ-hydroxybutyric acid before and after dialysis and compared with the measured values of empty stomach of 22 healthy volunteers. At the same time,we conducted the Pearson correlation analysis and multivariate linear regression of the values of the concentration change ofβ-hydroxybutyric acid before and after dialysis of patients of Hemodialysis group with the patient’s age,sex,triglyceride levels,cholesterol levels,BMI index,albumin,dialysis dehydration / dry weight ratios,glucose difference value before and after dialysis, difference value in serum creatinine before and after dialysis,whole urea clearance(KT/V),urea reduction rate(URR). Results ①the mean of the concentration change ofβ-hydroxybutyric acid in plasma of Hemodialysis group after dialysis is higher than that before dialysis. Both are significantly higher than that(P<0.05)of the control group;②the result of Pearson correlation analysis shows the difference value(P<0.05)of the concentration change ofβ-hydroxybutyric acid before and after dialysis is correlated with Albumin(R=-0.441),Hemoglobin(R=-0.366),difference value in serum creatinine before and after dialysis(R=0.288),Cholesterol value(R=-0.292). The result of multivariate linear regression shows the difference value before and after dialysis,serum-albumin,protopathy and age are the independent influence factors(P<0.05)in terms of the concentration change ofβ-hydroxybutyric acid before and after dialysis of maintenance Hemodialysis patients.Conclusion The internal concentration ofβ-hydroxybutyric acid of maintenance Hemodialysis patients is above the normal average level,the dialysis can improve theβ-hydroxybutyric acid in plasma,and the elevated levels are influenced by age,protopathy,serum albumin and the difference value of serum creatinine before and after dialysis.