生物电阻抗分析法预测并评估血液透析患者干体重  

Prediction and estimation of dry weight of patients with maintenance hemodialysis by bioelectrical impedance analysis

作　　者：李杏 毛慧娟 欧阳春 任海滨 张承宁 葛益飞 朱亚梅 邢昌赢 

机构地区：[1]南京医科大学第一附属医院肾脏病科,江苏省210029

出　　处：《江苏医药》2013年第15期1772-1775,I0001,共5页Jiangsu Medical Journal

摘　　要：目的应用生物电阻抗分析法预测并评估血液透析患者干体重。方法选择维持性血液透析的病情稳定患者141例,运用生物电阻抗仪测量透析前后细胞外液(ECW)、身体水分总量(TBW),并记录透析中血压的变化。根据ECW/TBW比值范围(0.36-0.39),将患者分为干体重达标组(A组,72例)与不达标组(B组,69例),分析A组透析后体重与ECW的线性回归关系。结果A组患者透析后体重与ECW呈显著正相关(P<0.01),其直线回归总体为y=0.146x+3.612(R2=0.500,P<0.01),男性y=0.104x+4.639(R2=0.602,P<0.01),女性y=0.119x+5.921(R2=0.413,P<0.01)。通过斜率相交法,可计算透析后患者预设干体重。A组与B组透析前后收缩压、舒张压的改变值差异无统计学意义(P>0.05)。结论生物电阻抗仪测量透析前后ECW有助于预测干体重,调整透析超滤脱水。仅通过监测血压变化不足以评估透析是否达到干体重。Objective To predict and evaluate the dry weight of patients with hemodialysis by bioelectrical impedance analysis.Methods The levels of extracellular water（ECW）and total body water（TBW）were measured by bioelectrical impedance apparatus and the change of blood pressure during dialysis was recorded in 141patient undergoing maintenance hemodialysis.According to the ratio of ECW to TBW（0.36-0.39）,those patients were divided into two groups of A（reaching the standard of dry weight,72cases）and B（higher or lower than the standard of dry weight,69cases）.The linear regression relationship between weight and ECW after hemodialysis in group A was analyzed.Results The weight of patients after hemodialysis was positively correlated with ECW in group A（P〈0.01）with the total,male and female line regressions of y=0.146x＋3.612（R2=0.500,P〈0.01）,y=0.104x＋4.639（R2=0.602,P〈0.01）and y=0.119x＋5.921（R2=0.413,P〈0.01）,respectively.The expected dry weight after hemodialysis could be calculated by the slope intersection method.There was no significant difference in the changes of diastolic blood pressure and systolic blood pressure between group A and group B（P〈0.05）.Conclusion Measurement of ECW before or after hemodialysis by bioelectrical impedance analysis is useful in predicting dry weight and adjusting ultrafiltration during hemodialysis.Only monitoring the changes of blood pressure is insufficient to assess whether the dry weight is appropriate or not.

关 键 词：生物电阻抗分析 干体重 血液透析 

分 类 号：R692[医药卫生—泌尿科学]