摘要
目的探讨多频生物电阻抗(MBIA)技术评价透析前慢性肾脏病(CKD)5期患者容量状态及其与肺动脉高压(PH)的相关性。方法回顾性分析2018年1月~2020年6月我院住院治疗的137例透析前CKD 5期患者的临床资料。所有患者在住院后同一天应用MBIA技术测量体液分布,采用超声心动图测量三尖瓣返流峰值速度(TRVmax)。根据TRVmax水平将CKD 5期患者分为PH组32例和非PH组105例。比较两组患者一般资料、实验室指标、MBIA参数及超声心动图参数。采用Spearman相关分析探讨MBIA参数与TRVmax的相关性,同时采用多元线性回归分析探讨影响TRVmax水平的相关因素。结果在MBIA技术测量的体液分布参数中,PH组患者的水过多(OH)、总体水(TBW)、细胞外液(ECW)、ECW占体质量的百分比(ECW%)、OH/ECW、ECW/TBW及ECW/细胞内液(ICW)明显高于非PH组,差异有统计学意义(均P<0.05)。在超声心动图参数中,PH组患者的左房内径(LAD)、左房容积指数(LAVI)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左室质量指数(LVMI)、二尖瓣早期血流速度(E)及E/舒张早期二尖瓣环速度(E/E′)明显高于非PH组,差异亦有统计学意义(均P<0.05)。Spearman相关分析结果显示,CKD 5期患者TRVmax与OH、TBW占体质量的百分比(TBW%)、ECW%、OH/ECW、ECW/TBW及ECW/ICW呈显著正相关(均P<0.05)。多元线性回归分析结果显示,TRVmax与ECW%、OH/ECW及ECW/TBW呈独立正相关(P<0.05)。结论MBIA技术测量的体液分布参数ECW%、OH/ECW、ECW/TBW与透析前CKD 5期患者的PH风险密切相关,为其独立危险因素。
Objective To explore the volume status evaluated by multi-frequency bioelectrical impedance(MBIA)in pre-dialysis patients with stages 5 chronic kidney disease(CKD)and its correlation with pulmonary hypertension(PH).Methods Clinical data of 137 pre-dialysis patients with stages 5 CKD admitted to The Second Affiliated Hospital of Hainan Medical University from January 2018 to June 2020 were analyzed in this retrospective study.MBIA was used to measure the patients'body fluid distribution,and echocardiography was used to measure the maximal tricuspid regurgitation velocity(TRVmax)in patients on the same day.According to TRVmax level,patients were divided into PH group(n=32)and non-PH group(n=105).The general data,laboratory parameters,MBIA parameters and echocardiography parameters were compared between the two groups.Spearman correlation analysis was used to explore the correlation between MBIA parameters and TRVmax,and multivariate linear regression analysis was used to explore the related factors affecting the level of TRVmax.Results Among the parameters of body fluid distribution measured by MBIA,the levels of Overyhydration(0H),total body water(TBW),extracellular water(ECW),percentage of ECW in body mass(ECW%),0H/ECW,ECW/TBW and ECW/intracellular water(ICW)in PH group were significantly higher than those in non-PH group(P<0.05).Among the echocardiographic parameters,left atrium dimension(LAD),left atrial volume index(LAVI),left ventricular end-diastolic dimension(LVEDD),left ventricular end-diastolic volume(LVEDV),Left ventricular mass index(LVMI),peak filling velocity in early diastole(E)and E/Early diastolic mitral annular velocity(E')in PH group were significantly higher than those in non-PH group(P<0.05).Spearman correlation analysis showed that TRVmax of patients with stages 5 CKD was significantly positively correlated with OH,percentage of TBW in body mass(TBW%),ECW%,OH/ECW,ECW/TBW,ECW/ICW(P<0.05).Multivariate linear regression analysis showed that TRVmax was independent positively correlated with ECW%,O
作者
麦湘湘
李柠肖
庄乙君
MAI Xiangxiang;LI Ningxiao;ZHUANG Yijun(Department of Ultrasound Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China;Department of Nephrology,The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China)
出处
《西部医学》
2021年第4期535-540,共6页
Medical Journal of West China
基金
海南省自然科学资金(819MS128)。
关键词
电阻抗
体液分布
三尖瓣返流峰值速度
肺动脉高压
慢性肾脏病
相关性
Electric impedance
Body fluid distribution
Maximal tricuspid regurgitation velocity
Pulmonary hypertension
Chronic kidney disease
Correlation
