中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2013年
11期
818-823
,共6页
生物电阻抗%血液透析%干体重
生物電阻抗%血液透析%榦體重
생물전조항%혈액투석%간체중
Bioimpedance%Hemodialysis%Dry-weight
目的 通过多频节段生物电阻抗法监测血液透析(HD)患者体液分布的变化,评估其在HD患者干体重调整中的作用.方法 选择大连医科大学附属第二医院透析中心维持性HD患者40例为研究对象(HD组);同期体检健康者102例为对照组.收集HD组及对照组的人口学资料;测量HD组透析前后及对照组患者的体重、身高、血压、多频节段生物电阻值,包括100 kHz、20 kHz频率下右上肢电阻抗(RRA)、躯干电阻抗(RTR)、右下肢电阻抗(RRL),并分别计算右上肢高频与低频电流下电阻抗的比值(RA-BIR)、躯干高频与低频电流下电阻抗的比值(TR-BIR)、右下肢高频与低频电流下电阻抗的比值(RL-BIR).选取HD组透析后TR-BIR和(或)RA-BIR高于对照组95％可信区间的患者8例,调整干体重,2个月后复测透析后的体重、血压、RA-BIR、TR-BIR、RL-BIR值.结果 (1)HD组患者透析前、后RA-BIR、TR-BIR、RL-BIR值均高于对照组,除透析后RL-BIR外,余指标的组间比较差异有统计学意义(P＜0.05);与透析前相比,透析后患者身体各部位的BIR均下降,其中RA-BIR、RL-BIR差异有统计学意义(P＜0.05).(2)经调整干体重,8例HD患者下调干体重后RA-BIR、TR-BIR、RL-BIR与对照组相比差异无统计学意义.与下调前相比,干体重下调后身体各部位BIR均下降,其中RA-BIR、RL-BIR下降前后组间比较差异统计学意义.与下调前相比,HD患者下调干体重后收缩压明显下降[(150.00±29.28)比(140.63±20.78) mm Hg,P＜0.05].结论 生物电阻抗法可用于指导调整HD患者干体重,其中上肢生物电阻抗值对干体重调整的指导意义更大;可参照健康人群的生物电阻抗范围来调整HD患者的干体重.
目的 通過多頻節段生物電阻抗法鑑測血液透析(HD)患者體液分佈的變化,評估其在HD患者榦體重調整中的作用.方法 選擇大連醫科大學附屬第二醫院透析中心維持性HD患者40例為研究對象(HD組);同期體檢健康者102例為對照組.收集HD組及對照組的人口學資料;測量HD組透析前後及對照組患者的體重、身高、血壓、多頻節段生物電阻值,包括100 kHz、20 kHz頻率下右上肢電阻抗(RRA)、軀榦電阻抗(RTR)、右下肢電阻抗(RRL),併分彆計算右上肢高頻與低頻電流下電阻抗的比值(RA-BIR)、軀榦高頻與低頻電流下電阻抗的比值(TR-BIR)、右下肢高頻與低頻電流下電阻抗的比值(RL-BIR).選取HD組透析後TR-BIR和(或)RA-BIR高于對照組95％可信區間的患者8例,調整榦體重,2箇月後複測透析後的體重、血壓、RA-BIR、TR-BIR、RL-BIR值.結果 (1)HD組患者透析前、後RA-BIR、TR-BIR、RL-BIR值均高于對照組,除透析後RL-BIR外,餘指標的組間比較差異有統計學意義(P＜0.05);與透析前相比,透析後患者身體各部位的BIR均下降,其中RA-BIR、RL-BIR差異有統計學意義(P＜0.05).(2)經調整榦體重,8例HD患者下調榦體重後RA-BIR、TR-BIR、RL-BIR與對照組相比差異無統計學意義.與下調前相比,榦體重下調後身體各部位BIR均下降,其中RA-BIR、RL-BIR下降前後組間比較差異統計學意義.與下調前相比,HD患者下調榦體重後收縮壓明顯下降[(150.00±29.28)比(140.63±20.78) mm Hg,P＜0.05].結論 生物電阻抗法可用于指導調整HD患者榦體重,其中上肢生物電阻抗值對榦體重調整的指導意義更大;可參照健康人群的生物電阻抗範圍來調整HD患者的榦體重.
목적 통과다빈절단생물전조항법감측혈액투석(HD)환자체액분포적변화,평고기재HD환자간체중조정중적작용.방법 선택대련의과대학부속제이의원투석중심유지성HD환자40례위연구대상(HD조);동기체검건강자102례위대조조.수집HD조급대조조적인구학자료;측량HD조투석전후급대조조환자적체중、신고、혈압、다빈절단생물전조치,포괄100 kHz、20 kHz빈솔하우상지전조항(RRA)、구간전조항(RTR)、우하지전조항(RRL),병분별계산우상지고빈여저빈전류하전조항적비치(RA-BIR)、구간고빈여저빈전류하전조항적비치(TR-BIR)、우하지고빈여저빈전류하전조항적비치(RL-BIR).선취HD조투석후TR-BIR화(혹)RA-BIR고우대조조95％가신구간적환자8례,조정간체중,2개월후복측투석후적체중、혈압、RA-BIR、TR-BIR、RL-BIR치.결과 (1)HD조환자투석전、후RA-BIR、TR-BIR、RL-BIR치균고우대조조,제투석후RL-BIR외,여지표적조간비교차이유통계학의의(P＜0.05);여투석전상비,투석후환자신체각부위적BIR균하강,기중RA-BIR、RL-BIR차이유통계학의의(P＜0.05).(2)경조정간체중,8례HD환자하조간체중후RA-BIR、TR-BIR、RL-BIR여대조조상비차이무통계학의의.여하조전상비,간체중하조후신체각부위BIR균하강,기중RA-BIR、RL-BIR하강전후조간비교차이통계학의의.여하조전상비,HD환자하조간체중후수축압명현하강[(150.00±29.28)비(140.63±20.78) mm Hg,P＜0.05].결론 생물전조항법가용우지도조정HD환자간체중,기중상지생물전조항치대간체중조정적지도의의경대;가삼조건강인군적생물전조항범위래조정HD환자적간체중.
Objective To evaluate fluid distribution in patients on maintenance hemodialysis (HD) by bioimpedance analysis and on the effect of adjusting the dry weight in hemodialysis patients.Methods Forty maintenance HD patients from the dialysis center of the Second Affiliated Hospital of Dalian Medical University were enrolled as study group.One hundred and two individuals who were tested of physical examination in the same hospital were enrolled as the control group.Sex and age of the two groups were recorded.Body weight,body high,blood pressure,bioimpedance of HD patients (pre-dialysis and post-dialysis) and controls were measured.Bioimpedance was measured by multifrequency segmental bioimpedance analysis,including right arm (RA) bioimpedance,trunk (TR) bioimpedance and right leg (RL) bioimpedance.Bioimpedance ratio (BIR) of three parts was calculated as of 100kHz and 20kHz including RA-BIR,TR-BIR and RL-BIR.Then eight HD patients who had high RA-BIA or TR-BIA according to the reference range which were obtained from 102 controls were chosen for dry weight adjustment.Post-dialysis body weight,blood pressure,and bioimpedance of the eight HD patients were measured again after adjusting the dry weight.Results (1) BIR of three parts in pre-dialysis HD patients were all significantly higher than that in the control group (P ＜ 0.05).BIR of three parts of the post-dialysis HD patients were still higher than that of the control group,but RL-BIR was not significantly (P ＞ 0.05).BIR of three parts of the post-dialysis HD patients were lower than BIR of three parts of the pre-dialysis HD patients,and there was significant different (P ＜ 0.05) with RA-BIR and RL-BIR.(2) After adjusting the dry weight,BIR of three parts of the post-dialysis HID patients were still higher than that of the control group,but none of them was significantly (P ＞0.05).BIR of three parts of the HD patients after adjusting the dry weight were lower than BIR of three parts of the HD patients before adjusting the dry weight,but there was no significant different with TR-BIR(P ＞ 0.05).After adjusting the dry weight,systolic blood pressure of the post-dialysis HD patients were significantly decrease[(150.00 ± 29.28) vs (140.63± 20.78) mm Hg,P＜ 0.05].Conclusions Bioimpedance analysis may be an effective method for adjusting dry weight in hemodialysis patients,and the bioimpedance of arms is the most effective method.The bioimpedance reference range of hemodialysis patients can be according to the reference range of normal individuals.
