在线监测尿素清除率评价血液透析充分性的研究  

ASSESSMENT OF HEMODIALYSIS ADEQUACY BY ONLINE UREA CLEARANCE MONITORING

作　　者：叶晴琳 朱柳莹[2] 王琳[1] 

机构地区：[1]中山市人民医院,广东中山528403 [2]南方医科大学第二临床医学院,广东广州510250

出　　处：《现代医院》2012年第6期28-30,共3页Modern Hospitals

摘　　要：目的探讨在线尿素清除率监测(DIASCAN)评价血液透析充分性的应用价值。方法选取2010年10月～2011年10月在我院行维持性血液透析的终末期肾衰患者共54例,采用DIASCAN检测尿素清除指数(Kt/V),在透析器首次使用及复用第五次时检测Kt/V,与同时应用尿素动力学单室可变容积模型计算Kt/V值进行统计学分析比较。结果首次使用时,透析器DIASCAN检测值低于Kt/V值,相关性分析显示两者存在直线相关性(r=0.811,p<0.01);复用第五次时,透析器DIASCAN检测值低于Kt/V计算值,相关性分析显示两者存在显著的直线相关性(r=0.592,p<0.01);透析器首次使用DIASCAN检测值和复用五次时DIASCAN检测值相比,差异无统计学意义(p>0.05)。透析每周2次与3次患者的单次血透DIASCAN检测值及Kt/V值相比无显著性差异(p>0.05)。结论在线尿素清除率监测值可以作为评价尿毒症患者血液透析充分性的一项较可靠指标,其低于应用尿素动力学计算的Kt/V值,二者呈显著正相关。Objective To evaluate the adequacy of hemodialysis by online urea clearance measurement （ DI ASCAN） in hemodialysis patients. Methods The Kt/V values of 54 maintenance hemodialysis patients with end stage renal failure in our hospital that were assessed by both DIASCAN and single pool urea kinetic model were compared, and the Kt/V values of patients in the first use dialyser and the 5th reused dialyser were also compared. Re suits In the patients who used a new dialyser, Kt/V values were 1.33 ±0. 41 measured by DIASCAN, whereas 1.58 ± 0. 69 by single pool urea kinetic model and there was a significant linear correlation （ r = 0. 811 ,p 〈 0. 01 ）. In the patients who used the fifth time used dialysers, Kt/V values measured by DIASCAN and single pool urea kinetic model also showed linear correlation （ r = 0. 592 ,p 〈 0.01 ）. In patients who applied the fifth time used dia lyser, Kt/V measured by DIASCAN and by model had no significant differences （p 〉 0. 05 ）. In patients undergoing dialysis two or three times per week, Kt/V measured by DIASCAN and by model also showed no differences （p 〉 0. 05 ）. Conclusion DIASCAN can be used as a comparative reliable index to assess the the adequacy of hemodialy sis of uremia patients, with the value lower than that of Kt/V from single pool urea kinetic model, but there is posi tive linear correlation between the two values.

关 键 词：在线监测 尿素清除率血液透析充分性Kt/V值 

分 类 号：R459.5[医药卫生—治疗学]