直接节段多频生物电阻抗分析技术评估血液透析患者干体质量的研究  

Application value of DSM-BIA in assessing dry weight of hemodialysis patients

作　　者：热那古·努尔热合曼提 杨文君[1] 帕热旦木·托乎提 Renagu Nuerremanti;Yang Wenjun;Paredanmu Tuohuti(Department of Nephrology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院肾病科,乌鲁木齐830054

出　　处：《中国医学装备》2024年第4期109-111,122,共4页China Medical Equipment

基　　金：新疆维吾尔自治区自然科学基金(2018D01C188)。

摘　　要：目的:探讨直接节段多频生物电阻抗(DSM-BIA)分析技术在血液透析患者干体质量(DW)评估中的应用。方法:选取2022年2月至2023年4月在新疆医科大学第一附属医院进行血液透析的96例患者,使用Kraemer评分表格半定量评估患者的容量状态,在行DSM-BIA技术检测之前,将患者的DW调整到Kraemer评分0分,并保持1周时间,并将此时的DW作为临床评估的标准。使用人体成分分析仪对透析患者的DSM-BIA参数进行测量,包括内瘘对侧上肢、躯干、下肢等50 kHz电阻抗值,以及测量患者身高、体重、血压以及体质量等相关辅助值,并记录其低血压、超滤量以及肌肉痉挛等其他并发症情况。结果:透析前与透析后内瘘对侧上肢通电50 kHz时的电阻抗值(R_(50))以及下肢R_(50)水平均显著高于躯干R_(50)水平,差异有统计学意义(t=63.835、51.858、47.338、62.886,P<0.01)。透析后内瘘对侧上肢R_(50)、躯干R_(50)以及下肢R_(50)水平均显著高于透析前,差异均有统计学意义(t=2.418、5.820、6.517,P<0.05)。患者平均DW为(67.42±12.98)kg,男性和(或)女性血液透析患者DW和生物电阻抗检测干体质量(DWDSM-BIA-CB)的一致性均较好。96例患者仅出现1例并发症。结论:DSM-BIA技术可以准确的反映患者的容量负荷、评估患者DW,并可减少患者透析并发症的发生率,具有很好的临床指导意义与临床应用价值。Objective:To explore the application of direct segmental multifrequency bioelectrical impedance analysis(DSM-BIA)technique in assessing the dry body weight(DW)of hemodialysis patients.Methods:A total of 96 patients who underwent hemodialysis in First Affiliated Hospital of Xinjiang Medical University from February 2022 to April 2023 were selected as participants.The Kraemer scale was used to semi quantitatively assess the volume status of hemodialysis patients.Before started the test of using DSM-BIA technique,the dry body weight of patients was adjusted to a Kraemer score to maintain 0 for a week,and the DW at this time was used as the clinical assessment standard.The human body composition analyzer was used to measure the DSM-BIA parameters of hemodialysis patients,which mainly included 50 kHz impedance values of the upper limb,trunk and lower limb on the opposite side of the internal fistula,as well as related auxiliary values such as height,weight,blood pressure and body mass of hemodialysis patients.The other complications such as hypotension,ultrafiltration volume and muscle spasms in hemodialysis patients were recorded.Results:The impedance values(R_(50))in 50 kHz of the upper and lower limbs on the opposite side of the internal fistula before and after dialysis were significantly higher than R_(50) level of the trunk(t=63.835,51.858,47.338,62.886,P<0.01).The R_(50) levels of the upper limb,trunk and lower limb on the opposite side of the internal fistula after dialysis were significantly higher than those before dialysis(t=2.418,5.820,6.517,P<0.05).The average DW value of patients was(67.42±12.98)kg,and the consistencies between DW and biological impedance testing for dry body weight(DWDSM-BIA-CB)in male and(or)female hemodialysis patients were favorable.Only one case occurred complication in 96 patients.Conclusion:DSM-BIA technique can accurately reflect the capacity load of patients,and accurately assess the dry body weight values of patients,and reduce the incidence of dialysis complications of patien

关 键 词：直接节段多频生物电阻抗(DSM-BIA) 血液透析 干体质量(DW) 

分 类 号：R459.5[医药卫生—治疗学]