应用直接节段多频生物电阻抗分析方法评价血液透析患者全身容量负荷变化的准确性

目的探讨运用直接节段多频生物电阻抗分析方法(direct segmental multi-frequency bioimpedance analysis:DSM-BIA)评估维持性血液透析患者全身容量负荷变化的准确性。方法应用DSM-BIA测量患者单次血液透析前全身总水量(Total body water by DSM-BIA before hemodialysis:TBWDSM-pre)及透析后全身总水量(Total body water by DSM-BIA after hemodialysis:⊿TBWDSM-post);同时应用以整体踝腕法为基础的人体构成频谱方程(body composition spectroscopy equations:BCSE)来计算透析前TBW(⊿TBWBCSE-pre)、透析后TBW(⊿TBWBCSE-post);将透析前后实际体质量的变化值当做实际脱水量(actualul trafiltration volume:AUV);分别将DSM-BIA、BCSE2种方法所得透析前后TBW的差值与AUV比较。结果由DSM-BIA测量透析前后体质量的变化与AUV有统计学差异(2.32±1.1与2.65±1.04L,t=2.962,P<0.01)。DSM-BIA测得透析前后TBW的差值与AUV有较好的一致性,虽然会低估AUV(-0.3±1.4L),不过相较于BCSE(-0.65±1.65L),DSM-BIA对AUV的评估更加准确。结论与BCSE方法相比,DSM-BIA可以更准确反应维持性血液透析患者的全身容量负荷的变化。

Validity of using direct segmental multi-frequency bioimpedance analysis method for estimating body volume status change in maintenance hemodialysis patients

Object To evaluate the accuracy of direct segmental multi-frequency bioimpedance analy- sis （DSM-BIA） method for estimation of body volume status changes during hemodialysis in maintenance hemodialysis patients. Methods Total body water were measured using each of DSM-BIA （TBWDsM.p , TBWosM.post） method and body composition spectroscopy equations （BCSE） method according to the whole body wrist -ankle protocol （TBWBcsE.pro, TBWBCSE-post） before and after the same hemodialysis session. The change of TBW detected using each of these two methods was compared to actual ultrafiltration volume（AUV） that was calculated as weight loss during hemodialysis session. Results DSM-BIA method detected TBW change （ TBWDsM：TBWdsm-pro-TBWDSM-post）was significantly different from AUV（2.32±1. 1 vs 2.65±1.04, t= 2. 962, P〈 0.01）, but/1 STBWosM has a better agreement with AUV than /1 TBWBcsE （-0.3±1.4 Lvs -0.65± 1.65 L）. Conclusions DSM-BIA provides a more accurate estimate of AUV during HD in maintenance hemodialysis patients than BCSE.