摘要
目的应用生物电阻抗分析法评估正常人群和临床评估达干体质量的透析患者体内水的含量及其分布特点，并比较在两组人群之间的差异。方法选石家庄市区健康志愿者240例作为对照组（A组），男120例，年龄（43．4±10．2）岁，记为A1组，女120例，年龄（44．7±13．5）岁，记为A2组；病例组（B组）选自2008年1～12月在我院血液净化中心临床法评估均达到千体质量的维持性血液透析的患者40例，男20例，年龄（45．6±10．8）岁，记为B1组，女20例，年龄（43．7±13．9）岁，记为B2组；所有患者均处于肾疾病的终未期，平均透析时间（20．0±7．2）个月。生物电阻抗测定并记录A组、B组透析前、B组透析后的总水含量占体质量的百分比（TBw％）、细胞外液占总水含量的百分比（ECW／TBWO）、细胞内液占总水含量的百分比（ICW／TBW％），与A组数据进行比较。同时密切观察并记录患者透析中的主诉、症状、血压、心率等。结果B1组TBw％透析前与A1组比较（71．83±7．83）％VS（60．53±4．98）％和透析后与A1组比较（70．63±7．43）％VS（60．53±4．98）％，差异均有统计学意义（P〈0．05），ECW／TBW％、ICW／TBW％则与A1组比较差异无统计学意义。②B2组TBw％透析前与A2组比较（71．28±10．38）％VS（59．07±6．73）％（P〈0．05）和透析后与A2组比较（69．41±8．17）％VS（59．07±6．73）％（P〈0．05），差异均有统计学意义，ECW／TBW％、ICW／TBW％则与A2组比较差异无统计学意义。结论①透析前患者TBW％高于正常人，增加的水在细胞内液和细胞外液是同步增加的。②透析后临床法评估达到干体质量的患者，用生物电阻抗测定TBw％仍高于正常人，说明临床评估干体质量的方法粗略，不精确。③生物电阻抗分析法通过对人体内水含量及其分布的测定，对干体质量的评估比临床法更准确。
Objective To use bioelectrical impedance analysis for estimating the body water content and its distribution features both in normal population and dialysis patients who reached dry mass, then to compare the difference between the two groups. Methods 240 healthy volunteers in Shijiazhuang served as controls （A group） ,in the group 120 men were assigned in A1 group,age （43.4±10.2） years old;120 women in A2 group,age （44, 7±13.5） years old; 40 patients who were undergoing dialysis treatment in the hemopurification center at the hospital were selected from 2008 Jan-Dec,these dialysis patients reached dry mass,in the group 20 men were assigned in B1 group, age （45.6±10.8） years old,20 women in 132 group,age （43.7± 13.9） years old. All the patients were in the final stages of renal disease. The average duration of dialysis was （20.0 ± 7.2） months. Using bioelectrical impedance analysis,we measured T＇BW%, ECW/TBW~, ICW/TBW% in A group, 13 group predialysis and postdialysis, then compared with the data from A group, at the same time, we also observed and recorded the patients＇ symptoms,blood pressure, heart rate,etc. Results C）Compared with A group,TBW% in B1 group before and after dialysis both had statistical significance（71.83±7.83） % vs （60.53± 4.98） % ; （70.63 ± 7.43） % vs （60.53± 4.98） % （ P 〈0.05）, ECW/TBW%, ICW/TBW% had no statistical significance. QCompared with A2 group,TBW% in B2 group before and after dialysis both had statistical significance （71.28 ± 10.38 ） % vs （ 59.07 ± 6.73 ） %; （ 69.41 ± 8.17 ） vs （ 59.07 ± 6.73 ） （ P〈 0.05）, ECW/TBW%, ICW/TBW% had no statistical significance. Conclusion ① TBW% in patients before hemodialysis is higher than that in normal population,and water either in the intracellular fluid or extracellular fluid is simultaneously increased. ②After hemodialysis,TBW% in patients who achieved dry mass is still higher than that in normal population, indicating the method of clinical assessment of dry mass is imprecise. ③Bioelectrical impedance analysis is more accurate than clinical assessment in evaluating the dry body mass by measuring human total body water and its distribution.
出处
《临床荟萃》
CAS
2010年第11期936-938,942,共4页
Clinical Focus
关键词
肾透析
电阻抗
体重变化
renal dialysis
bioelectrical impedance
body weight changes
