生物电阻抗分析在持续不卧床腹膜透析患者容量评估中的临床应用  

Clinical application of bioelectrical impedance on assessment of volume status in continuous ambulatory peritoneal dialysis patients

作　　者：马亚琪 田娜[1] 付丽娜[1] 陈孟华[1] MA Yaqi;TIAN Na;FU Lina;CHEN Menghua(Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan 750004, Chin)

机构地区：[1]宁夏医科大学总医院肾脏内科,宁夏银川750004

出　　处：《宁夏医学杂志》2018年第3期251-254,I0001,共5页Ningxia Medical Journal

基　　金："十二五"国家科技支撑计划项目(2011BAI10B08)

摘　　要：目的探讨生物电阻抗在持续不卧床腹膜透析(CAPD)患者容量评估中的临床应用价值。方法纳入规律随访的CAPD患者用临床评估和生物电阻抗分析(BIA)两种方法对患者的容量状况进行评估并收集其临床资料,按BIA监测值中体内水剩余情况(OH),将患者分为2组,OH>2.5为容量超负荷组(FO组),OH≤2.5为非容量超负荷组(N-FO组),对比2组患者的临床及实验室指标差异。结果共纳入65例CAPD患者,平均年龄(48.7±13.8)岁,中位透析龄15(5.72)个月。以临床标准评价为FO的患者13例(20.0%),以BIA诊断为FO的患者14例(21.54%)。采用ROC曲线以临床常规方法为参照评价BIA方法的敏感性和特异性,OH曲线下面积0.942,敏感度0.923,特异度0.038,P<0.05,有统计学意义。FO组患者的血清白蛋白、血钙明显低于N-FO组,而总体水、细胞外液明显高于N-FO组,差异有统计学意义(P<0.05)。结论 BIA法对于诊断腹膜透析患者容量超负荷的敏感性及特异性较高,具有很好的临床应用价值;容量超负荷的腹膜透析患者血清白蛋白、血钙较低。Objective To explore the clinical application of bioelectric impedance analysis （BIA） on assessment of volume status in continuous ambulatory peritoneal dialysis （CAPD） patients. Methods A cross -sectional control study was conducted. CAPD patients were enrolled. The patients＇ volume status was assessed by both clinical method and the BIA. The clinical data were collected during the same period. The patients were divided into fluid overload group （FO group） when the overhydration （OH） 〉 2.5 and none - fluid overload （ N - FO group） when the OH ≤2.5. The clinical and laboratory indexes were compared between the two groups. Resuits A total of 65 CAPD patients were enrolled in this study with an average age of 48.7 ± 13.8 years and median vintage of 15 （5, 72） months;13 patients （21.6%） were diagnosed as FO according to clinical method while 14 （21.54%） were diagnosed by BIA. ROC curve was used to evaluate the sensitivity and specificity of BIA. The area under the OH curve was 0. 942, sensitivity was 0.923, specificity was 0.038 （P 〈 0.05 ）. Compared clinical data between the two groups ： the level of serum albumin （34.47 ±3.56 vs. 38. 92±.18 g/L,P 〈0.05） and serum calcium were lower in the FO group than the N - FO group. While the TBW and ECW were higher in the FO group than those in N - FO group. There were no statistical differences between the two groups on the indexes such as height, weight, systolic blood pressure, diastolic blood pressure, serum phosphorus, C reactive protein, triglyceride, high density lipoprotein, low density lipoprotein, total cholesterol, parathyroid hormone, hemoglobin, serum sodium and urine volume. Conclusion BIA has sensitivity and specificity for diagnosing volume overload in peritoneal dialysis patients. Peritoneal dialysis patients with volume overload have lower serum albumin and lower blood calcium.

关 键 词：腹膜透析 容量超负荷 生物电阻抗分析 

分 类 号：R692.5[医药卫生—泌尿科学]