维持性血透患者stdKt/V与相关临床指标关系及应用价值  

Relationship between stdKt/V and related clinical indicators in patients with maintenance hemodialysis and its application value

作　　者：陈安珉 黄建槐 陈蕴 汤静 夏文亚 冯锦红 CHEN Anmin;HUANG Jianhuai;CHEN Yun;TANG Jing;XIA Wenya;FENG Jinhong(Department of Nephrology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学附属医院肾脏内科,江苏徐州221002

出　　处：《徐州医科大学学报》2023年第7期492-498,共7页Journal of Xuzhou Medical University

摘　　要：目的探讨维持性血透患者标准尿素清除指数(stdKt/V)与相关临床指标关系及应用价值。方法选取在徐州医科大学附属医院血液净化中心治疗的105例维持性血液透析患者资料,根据stdKt/V达标情况进行分组,采用单因素及多重线性回归分析法筛选stdKt/V的独立影响因素。根据stdKt/V及尿素清除指数(Kt/V)不同达标情况进行分组研究,比较stdKt/V与Kt/V的差异。将stdKt/V>2.0的患者根据透析频率分组研究,比较2组患者一般资料和实验室检查结果,探究stdKt/V的应用价值。结果与stdKt/V≤2.0组相比,stdKt/V>2.0组患者血钙、血清白蛋白水平较高,干体质量较小,透析龄较短。多重线性回归分析显示干体质量、血清白蛋白水平与stdKt/V呈线性相关,是stdKt/V的独立影响因素。与均达标组患者相比,Kt/V不达标、stdKt/V达标组患者Kt/V值较低,具有残余肾功能的患者比例较高,Kt/V达标、stdKt/V不达标组患者2次/周透析方案的患者比例较高。与3次/周组相比,2次/周组患者的Kt/V值较低,透析龄更短,超滤量较大,残余肾功能、肾小球滤过率(eGFR)水平方面更高,余临床及血液学参数相比差异无统计学意义。结论stdKt/V纳入透析患者营养状况及患者体内容量控制情况。应用stdKt/V作为衡量透析充分性的指标,可筛选出stdKt/V和Kt/V达标情况存在差异的患者(尤见于具有残余肾功能、每周透析2次的患者),弥补Kt/V的不足。也可有效筛选出每周透析2次患者中透析充分的人群,更全面地评估透析充分性。Objective To investigate the relationship between stdKt/V and related clinical indicators in patients with maintenance hemodialysis and its application value.Methods A total of 105 patients who underwent maintenance hemodialysis in Hemodialysis Center,the Affiliated Hospital of Xuzhou Medical University were selected.According to the achievement of stdKt/V,they were divided into different groups.The univariate and multiple linear regression analysis were used to screen the independent influencing factors of stdKt/V.The patients were grouped according to their stdKt/V and Kt/V values,and the differences between stdKt/V and Kt/V were compared.Patients with stdKt/V>2.0 were investigated in groups according to dialysis frequency.Both groups were compared for general information and laboratory examination results,in order investigate the application value of stdKt/V.Results Patients in the stdKt/V>2.0 group showed higher levels of blood calcium and serum albumin,smaller dry body mass,and lower dialysis age than those in the stdKt/V≤2.0 group.Multiple linear regression analysis showed that dry body mass and serum albumin levels were linearly correlated with stdKt/V,which were the independent factor of stdKt/V.Compared with patients in the all-attainment group,patients in the stdKt/V attainment and Kt/V non-attainment group had lower Kt/V values,with a higher proportion of residual renal function;there were a higher proportion of patients using dialysis twice/week regimen in the stdKt/V non-attainment and Kt/V attainment group.Compared with the three-times/week group,patients in the twice/week group had reduced Kt/V values,decreased dialysis age,increased ultrafiltration,and enhanced residual renal function and eGFR levels,without statistical differences in the remaining clinical and hematological parameters.Conclusions stdKt/V incorporates the nutritional status of dialysis patients and the volume control of the patient′s body.Application of stdKt/V as a measurement of dialysis adequacy can screen out patients with

关 键 词：终末期肾病 维持性血液透析 透析充分性 标准尿素清除指数 

分 类 号：R446[医药卫生—诊断学]