基于生物电阻抗技术的持续性非卧床腹膜透析患者容量负荷状态分析及影响因素研究  

Analysis the effect factors and volume load on the patients with continuous ambulatory peritoneal dialysis by multiple frequency bioelectrical impedance analysis(MFBIA)

作　　者：洪敏[1] 张瑞敏[1] 王秀川[1] 李怡冰 商悦军[1] 郑红光[1] 

机构地区：[1]沈阳军区总医院肾脏病科,辽宁沈阳110840

出　　处：《中国实用内科杂志》2016年第4期323-326,共4页Chinese Journal of Practical Internal Medicine

基　　金：全军"十二五"重点课题(BSY-13C002);科技部十二五支撑项目(2011BA10B08)

摘　　要：目的采用多频生物电阻抗技术评估方法,探讨持续性非卧床腹膜透析(CAPD)患者容量负荷状态及影响因素。方法以2006年1月至2013年12约期间沈阳军区总医院腹膜透析中心管理的60例CAPD患者为研究对象,分析60例无显性水肿CAPD患者的临床资料。结果容量超负荷患者34例(56.67%),该组收缩压、年龄、C-反应蛋白水平均显著高于容量正常组(P<0.05),而Alb、残肾功能、每周尿素和肌酐清除率均低于容量正常组(P均<0.01)。炎症组(31例)平均年龄(P<0.05)、细胞外液(ECW)/身体总液体(TBW)比值(P<0.01)以及收缩压水平(P<0.01)均高于非炎症组(29例);白蛋白(Alb)、每周肌酐清除率水平均低于非炎症组,差异有统计学意义(P<0.01)。容量负荷与年龄、收缩压、C反应蛋白(CRP)呈正相关,与Alb、TP呈负相关(P均<0.01)。结论 (1)采用多频生物电阻抗技术可更早发现CAPD患者的容量失衡;(2)年龄、收缩压、残肾功能、尿素清除率、白蛋白、C-反应蛋白均是CAPD患者容量负荷的影响因素;(3)CAPD患者容量负荷与年龄、营养状态及炎症密切相关。Objective We used Multiple frequency bioelectrical impedance analysis（MFBIA） to investigate the volume load and the influence factors on the patients with continuous ambulatory peritoneal dialysis（CAPD）. Methods We collected the clinical data of 60 patients of CAPD without obviously edema.Results The systolic blood pressure, ages, C - reactive protein level in 34 cases （56.67%） with Volume overload were higher than normal group （26 cases） while Alb;while those patients＇ residual renal function, weekly urea clearance index, and weekly creatinine clearance capacity were lower than normal group （P 〈 0.05）. In malnutrition group （ 37 cases）, the age, ECW（extra cellular water）/TBW（total body water） （P〈0.01）,systolic blood pressure, C - reactive protein were higher than normal nutrition group （23 cases） （P〈 0.05）. In inflammation group （31 cases）, the ECW/TBW, systolic blood pressure, age, were higher than those in unincorporated inflammation group （29 cases）, while weekly creatinine clearance, serum albumin, are lower than the unincorporated inflammation group（P〈0.05）. ECW/TBW was positively correlated with age, systolic blood pressure, and CRP, and was negatively correlated with Alb, total protein（TP）. Conclusion Multiple frequency bioelectrical impedance analysis （MFBIA） is a simple effective method for earlier clinical findings of volume overload in CAPD patients.The influence factors of volume load in CAPD patients are include： age, SBP, RRF, TwKt/v, Ccr and CRP levels.Volume status of CAPD patients has a strong correlation with nutrition indicators, inflammation, age, systolic blood pressure, and TwKt/v.

关 键 词：持续性非卧床腹膜透析 容量负荷 多频生物电阻抗 

分 类 号：R692.5[医药卫生—泌尿科学]