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目的探讨生物电阻抗指标评价慢性肾脏病5期血液滤过患者血容量与心脏结构及功能的价值。方法慢性肾脏病5期行血液滤过治疗患者52例(CKD组),以血液滤过中中心静脉压6~12cm H2O为容量平衡标准,观察患者治疗前、后中心静脉压、血生化指标及心脏超声结果;以健康成人52例为对照组,测量对照组及CKD组治疗前、后生物电阻抗指标。结果 (1)CKD组治疗前中心静脉压为(16.34±3.47)cm H2O,细胞外液占总体水含量百分比(percentage of extracellular fluid in total body water,ECW/TBW%)为(27.86±3.52)%、总水含量占体质量百分比(percentage of total water in body weight,TBW%)为(58.68±5.23)%,治疗后以上指标分别为(9.25±3.51)cm H2O、(24.67±3.55)%、(56.57±4.35)%,治疗前后比较差异有统计学意义(P<0.01);(2)CKD组治疗后室间隔厚度[(11.45±0.96)mm]、左心室后壁厚度[(10.76±0.95)mm]、左室射血分数[(62.74±4.02)%]与治疗前[(11.97±1.13)mm、(11.25±0.92)mm、(60.35±4.66)%]比较差异有统计学意义(P<0.05);(3)CKD组治疗后ECW%/TBW、TBW%与对照组[(24.33±3.48)%、(55.36±3.89)%]比较差异无统计学意义(P>0.05)。结论生物电阻抗指标可准确评估慢性肾脏病5期患者容量负荷。
Objective To investigate the value of bioelectrical impedance index in evaluating blood volume, cardiac structure and function in patients with stage 5 hemofiltration of chronic kidney disease. Methods Fifty-two patients with chronic kidney disease (CKD group) undergoing hemofiltration were enrolled in this study. The central venous pressure, hemoglobin and blood biochemical parameters before and after treatment were measured with 6 ~ 12cm H2O of central venous pressure in hemofiltration. Echocardiographic results; 52 healthy adults as a control group, measurement of the control group and CKD group before and after treatment of bioelectrical impedance index. Results Before treatment, the central venous pressure in CKD group was (16.34 ± 3.47) cm H2O, and the percentage of extracellular fluid in total body water (ECW / TBW%) was (27.86 ± 3.52)% , The total water content accounted for (58.68 ± 5.23)% of the percentage of total water in body weight (TBW%), the above indexes were (9.25 ± 3.51) cm H2O, (24.67 ± 3.55)% and (P <0.01); (2) The thickness of the interventricular septum in the CKD group [(11.45 ± 0.96) mm], the thickness of the posterior wall in the left ventricle [(10.76 ± 0.95) mm] and left ventricular ejection fraction [(62.74 ± 4.02)%] were significantly different from those before treatment [(11.97 ± 1.13) mm, (11.25 ± 0.92) mm, (60.35 ± 4.66)%] 0.05). (3) There was no significant difference in ECW% / TBW and TBW% between CKD group and control group [(24.33 ± 3.48)%, (55.36 ± 3.89)%]. Conclusions The bioelectrical impedance index can accurately assess the volume load of patients with stage 5 chronic kidney disease.