血液透析患者下腔静脉直径／体表面积变化及意义

目的观察血液透析患者下腔静脉直径／体表面积（VCD）变化并探讨其意义。方法选择89例血液透析患者（透析组），于透析前及透析后1h采用飞利浦彩色多普勒超声测量下腔静脉直径，计算VCD；另选择与透析组相匹配的89例体检正常者为对照组，比较两组VCD。测量超滤量≥2．5kg及〈2．5kg透析前后VCD。采用Cox回归分析法对VCD与超滤量的关系行相关性分析。结果透析组透析前及透析后1h的VCD分别为（9．92±0．99）、（9．01±1．43）mm／m^2，透析前后比较，P〈0．05；对照组VCD为（8．88±1．29）mm／m^2，与透析组透析前比较，P〈0．05。超滤量≥2．5蚝者透析前后VCD分别为（9．93±1．78）、（8．90±1．31）mm／m^2，透析前后比较P〈0．05；超滤量〈2．5kg者透析前后VCD分别为（9．30±1．21）、（9．02±1．10）mm／m^2，透析前后比较P〉0．05。超滤量≥2．5kg时超滤量与VCD呈负相关（r=-0．928，P〈0．05）。结论血液透析患者透析后VCD明显降低；超滤量≥2．5kg时VCD与超滤量呈负相关；VCD能初步判定患者体液处于平衡状态时的体质量，可作为超滤量≥2．5奴时血液透析量的调节指标。

Changes and significance of inferior vena cava diameter/body surface area in patients under treatment of hemodialysis

Objective To observe the changes and significance of inferior vena cava diameter/body surface area （VCD） in patients under treatment of hemodialysis. Methods Eighty-night patients under hemodialysis were selected as the hemodialy- sis group, meanwhile, another 89 healthy people were selected as the control group. We measured their inferior vena cava diame- ter before and 1 h after dialysis by using color Doppler ultrasound, and calculated and compared the VCD between the two groups. The VCD was measured before and after dialysis （ultrafiltration volume≥2.5 kg or 〈2.5 kg）. Cox regression analysis was used to analyze relationship between V CD and ultrafiltration volume. Results The V CD was （9. 92 ± 0. 99）mm/m^2 before dialysis and was approximately （9.01 ±1.43） mm/m^2 1 h after dialysis in the hemodialysis group （P 〈0.05）. VCD value in the control group was（8.88 ± 1.29）mm/m^2. When patients with ultrafiltration volume t〉2. 5 kg, the VCD before and after hemodial- ysis were separately （9.93 ±1.78） and （8.90 ± 1.31 ） mm/rn2 （P 〈 0. 05 ） ; When patients with ultrafihration volume 〈 2. 5 kg, the VCD before and after hemodialysis were separately （9.30 ± 1.21 ） and （9.02 ± 1.10） mm/m^2（ P 〉 0. 05 ）. The ultrafihration volume （ ≥2.5 kg） was negatively correlated with the VCD （r = -0.928, P 〈0.05）. Conclusions The VCD is Significantly lower in patients after hemodialysis, and the ultrafiltration volume （ I〉2.5 kg） is negatively correlated with the VCD. VCD may initially determine the body mass of patients in the equilibrium state, and can also be used as regulating index when the ultrafil- tration volume is greater than or equal to 2.5 kg during the hemodialysis.