生物电阻抗评估维持性血液透析患者的容量状态与残余肾功能的关系  

Bioelectrical Impedance Assessment of the Relationship Between Volume Status and Residual Renal Function in Maintenance Hemodialysis Patients

作　　者：邹媛媛 李炬楠 刘静[1] 史应进[2] ZOU Yuanyuan;LI Junan;LIU Jing;SHI Yingjin(Inner Mongolia University of Science and Technology Baotou Medical College,Baotou 014040 China;Department of Nephrology,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014040 [2]内蒙古科技大学包头医学院第一附属医院肾内科,内蒙古包头014010

出　　处：《内蒙古医学杂志》2023年第4期391-394,共4页Inner Mongolia Medical Journal

摘　　要：目的应用多频生物电阻抗法(BIA)评估维持性血液透析(MHD)患者容量状态,探究其与残余肾功能(RRF)的关系,为临床治疗提供参考。方法收集2021年11月至2022年9月于包头医学院第一附属医院血液透析室接受血液透析超过6个月的患者128例,并对其进行规律随访,每3个月随访1次,共随访3次,记录患者一般信息、实验室指标、胱抑素C等资料,采用BIA测量患者透析前总体液(TBW)、细胞外液(ECW)和细胞内液(ICW)、细胞外液/细胞内液(E/I)、细胞外液/总体液(E/T),根据E/T值将患者分为容量过载组(E/T≥0.400)和非容量过载组(E/T<0.400),比较不同容量状态间RRF(用胱抑素C计算:RRF=0.70+22/CysC)有何不同;分析RRF与容量指标的相关性及RRF下降率与容量指标的多重线性回归关系。结果(1)透析前容量过载组RRF高于非容量过载组且透析前容量过载组RRF下降率低于非容量过载组,差异有统计学意义(P<0.05);(2)MHD患者RRF与透析前E/T(r=0.58,P<0.05)呈正相关;(3)透析前ECW每增加一个单位,RRF下降率减少0.041 mL/(min·1.73 m^(2)·month)(P<0.05,95%CI:-0.048~0.112);透析前E/T每增加一个单位,RRF下降率减少0.102 mL/(min·1.73 m^(2)·month)(P<0.05,95%CI:-0.129~0.176)。结论(1)MHD患者处于容量过载状态不仅可以保护其RRF,还能降低RRF的下降率;(2)BIA可以反映患者体内液体分布情况,有利于更好地管理患者的容量问题。Objective To evaluate the volume status of maintenance hemodialysis(MHD)patients with multifrequency bioelectrical impedance(BIA),and explore the relationship between the volume status and residual renal function(RRF),so as to provide reference for clinical treatment.Methods From November 2021,to Sep⁃tember 2022 A tatal of 128 patients who received hemodialysis in the hemodialysis room of the First Affiliated Hos⁃pital of Baoyi Hospital for more than 6 months were collected and followed up regularly.They were followed up once every three months for a total of three times.The general information,laboratory indicators,cystatin C and other data of the patients were recorded.The total fluid(TBW),extracellular fluid(ECW),intracellular fluid(ICW),extracellular fluid/intracellular fluid(E/I)Extracellular fluid/total fluid(E/T).According to the E/T value,pa⁃tients were divided into volume overload group(E/T≥0.400)and non-volume overload group(E/T<0.400).Compare the difference of RRF(calculated by cystatin C:RRF=0.70+22/SysC)between different volume states;Analyze the correlation between RRF and capacity indicators and the multiple linear regression relationship between RRF decline rate and capacity indicators.Results(1)The RRF of the volume overload group before di⁃alysis was higher than that of the non-volume overload group,and the RRF decline rate of the volume overload group before dialysis was lower than that of the non-volume overload group,the difference was statistically signifi⁃cant(P<0.05);(2)RRF of MHD patients was positively correlated with E/T before dialysis(r=0.58,P<0.05);(3)For each unit of ECW increase before dialysis,the RRF decrease rate decreased by 0.041 mL/(min·1.73 m^(2)·month)(P<0.05,95%CI:-0.048~0.112);For each unit of E/T increase before dialysis,the RRF decrease rate decreased by 0.102 mL/(min·1.73 m^(2)·month)(P<0.05,95%CI:-0.129~0.176).Conclu⁃sion(1)MHD patients in the state of capacity overload can not only protect their RRF,but also reduce the de⁃cline rate of RRF;(2)BIA

关 键 词：维持性血液透析 多频生物电阻抗 残余肾功能 

分 类 号：R459.5[医药卫生—治疗学]