应用生物电阻抗法评估维持性血液透析患者体液状况的探讨

目的探讨生物电阻抗法（bioeleetricalimpedanceanalysis，BIA）对维持性血液透析（MHD）患者体液状况的临床价值。方法选择行MHD的稳定患者93例（实验组）及健康志愿者109例（对照组），并按性别分组。实验组按BIA检测时间分为血液透析前组（A组）、血液透析后组（B组）及下次血液透析前组（C组）。应用生物电阻抗仪，测算各组的细胞外液占体质量的百分比（ECV％）、细胞内液占体质量的百分比（ICV％）、身体水分总量占体质量的百分比（TBW％）、细胞外液／细胞内液（ECV／ICV）及浮肿指数（ECW／TBW）。比较各组间相关指标的差异。结果①在年龄相当时，女性体质量、身高均以实验组低。②对照组、A组、B组和3组之间的ECV％、ECV／ICV及ECW／TBW的差异均有统计学意义（P〈O．05）；无性别差异。实验组女性ICV％、TBW％大于对照组。③ECV％、ECV／ICV、ECW／TBW以B组最小。结论MHD患者存在营养不良，女性患者更常见。ECV％、ECV／ICV、ECW／TBW可作为监测MHD患者体液状况的指标。BIA在评估MHD患者体液状况方面值得进一步研究。

Assessment of Body Fluid Status in Patients with Maintenance Hemodialysis by Bioelectrical Impedance Analysis

Objective To explore the clinical value of bioelectrical impedance analysis for evaluating body fluid status in maintenance hemodialysis patients Methods Ninety-three cases of stable patients （ex- perimental group） undergoing maintenance hemodialysis and 109 cases of the control group were recruited, and grouped by gender. The experimental group was subdivided into pre-hemodialysis subgroup （A）, post- hemodialysis subgroup （B） and the next pre-hemodialysis subgroup （C） by BIA detection period. ECV%, ICV%, TBW%, ECV/ICV and ECW/TBW in each group were estimated. The difference in the related in- dicators among groups was observed. Results （1） In age-matched, female body mass and height were re- duced in the experimental group~ （2） There was significant difference in ECVM, ECV/ICV and ECW/TBW among control group, subgroup A and subgroup B （P（0. 05）. There was no difference between sexes. ICV~ and TBWM in the females of the experimental group were larger than the control group; （3） ECV%, ECV/ICV and ECW/TBW were the smallest in the subgroup t3. Conclusions There exists malnu- trition in patients undergoing maintenance hemodialysis, more common in females ECV%, ECV/ICV and ECW/TBW can be used as indicators for monitoring fluid status in MHD patients. Assessment of body fluid status by BIA in MHD patients deserves further study.