生物电阻抗相位角对维持性血液透析患者低蛋白血症的预测价值  

Predictive value of bioelectrical impedance phase angle for hypoalbuminemia in maintenance hemodialysis patients

作　　者：梁威锋 刘云 许世林 陈文璇 谭荣韶 刘岩 钟小仕 LIANG Wei-feng;LIU Yun;XU Shi-lin;CHEN Wen-xuan;TAN Rong-shao;LIU Yan;ZHONG Xiao-shi(Departmen of Nephrology,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Institute of Clinical Pathological Nutrition,Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州市红十字会医院肾内科,广州510220 [2]广州市红十字会医院临床病态营养研究所,广州510220

出　　处：《中国血液净化》2022年第7期478-482,共5页Chinese Journal of Blood Purification

摘　　要：目的 评价生物电阻抗相位角(phase angle,PhA)对维持性血液透析(maintenance hemodialysis,MHD)患者低蛋白血症的预测价值。方法 本研究为单中心横断面研究,纳入2021年3月在广州市红十字会医院血液净化中心行MHD的患者136例,收集基本资料、生化指标、透析相关指标和透析前生物电阻抗测量数据。将患者分为低蛋白血症组(34例)和非低蛋白血症组(102例),比较2组临床特征,应用单变量和多变量分析明确低蛋白血症的相关因素;采用受试者工作特征曲线(ROC)分析相位角对低蛋白血症的诊断价值。结果 与非低蛋白血症组相比,低蛋白血症组有较低的PhA(Z=8.715,P<0.001);Sperman法分析显示相位角和白蛋白呈正相关(r=0.609,P<0.001);多因素二分类Logistic回归提示,较低的PhA、血清钙是MHD患者发生低蛋白血症的独立相关因素(OR=5.148,95%CI:2.550~10.394,P<0.001;OR=15.857,95%CI:1.302~193.170,P=0.030)。ROC曲线提示PhA诊断MHD患者低蛋白血症的最佳临界值为3.85°(AUC=0.815,95%CI:0.736~0.895,P<0.001)。结论 低PhA值是MHD患者发生低蛋白血症的独立影响因素。Objective To evaluate the predictive value of bioelectrical impedance phase angle(PhA)for hypoalbuminemia in maintenance hemodialysis(MHD)patients.Methods This was a single-center and crosssectional study.A total of 136 patients who underwent MHD in our center in March 2021 were enrolled.Their basic information,biochemical indicators,dialysis-related indicators and pre-dialysis bioelectrical impedance measurement data were collected.The patients were divided into a hypoalbuminemia group(34 cases)and a non-hypoproteinemia group(102 cases).Clinical characteristics of the two groups were compared.Univariate and multivariate analysis were used to identify the related factors of hypoalbuminemia.The diagnostic value of PhA for hypoalbuminemia was analyzed using the receiver operating characteristic curve(ROC).Results Compared with the non-hypoalbuminemia group,the hypoalbuminemia group had lower PhA(Z=8.715,P<0.001).Spearman's analysis showed that PhA and serum albumin were positively correlated(r=0.609,P<0.001).Multivariate dichotomous logistic regression showed that lower PhA and serum calcium were the independent factors for hypoalbuminemia in MHD patients(OR=5.148,95%CI:2.550~10.394,P<0.001;OR=15.857,95%CI:1.302~193.170,P=0.030).ROC curve suggested that the optimal cut-off value of PhA for the diagnosis of hypoalbuminemia in MHD patients was 3.85°(AUC=0.815,95%CI:0.736~0.895,P<0.001).Conclusion Lower PhA value is an independent influencing factor for hypoalbuminemia in MHD patients.

关 键 词：维持性血液透析 低蛋白血症 生物电阻抗分析 相位角 

分 类 号：R459.5[医药卫生—治疗学]