目的探讨生物电阻抗分析法(BIA)指导超滤量同常规临床方法相比对血液透析患者残余肾功能(RRF)的影响。方法计算机检索2022年12月31日前发表在PubMed、Cochrane Library、Embase、Web of Science等英文数据库以及中国知网、维普数据库、...目的探讨生物电阻抗分析法(BIA)指导超滤量同常规临床方法相比对血液透析患者残余肾功能(RRF)的影响。方法计算机检索2022年12月31日前发表在PubMed、Cochrane Library、Embase、Web of Science等英文数据库以及中国知网、维普数据库、万方医学和中国生物医学文献数据库等中文数据库,探讨应用BIA指导超滤量同常规临床方法相比对血液透析患者RRF影响的随机对照试验(RCT),采用RevMan 5.4软件进行meta分析。结果最终纳入6篇文献,共计406名受试者。meta分析结果显示随访结束后BIA指导组的患者RRF(P<0.05,MD=1.15,95%CI:1.00~1.31)、24 h尿量(P<0.05,MD=253.56,95%CI:229.17~277.96)均高于对照组,超滤量(P<0.05,MD=-0.45,95%CI:-0.65~-0.26)及舒张压(P<0.05,MD=-5.52,95%CI:-7.58~-3.47)均低于对照组;两组患者的收缩压(P>0.05,MD=-0.25,95%CI:-7.70~7.21)、体质量(P>0.05,MD=-0.01,95%CI:-3.38~3.37)、白蛋白(P>0.05,MD=0.41,95%CI:-1.61~2.43)比较,差异均无统计学意义。结论基于现有研究,在营养管理及容量管理过程中采用BIA指导超滤量同常规临床方法相比有助于保护血液透析患者的RRF。展开更多
目的探索接受血液透析的终末期肾病(end-stage renal disease,ESRD)患者液体状态和肺功能之间的关系。方法2019年4月~10月,纳入在辽阳市中心医院血液净化中心接受血液透析的ESRD患者54例。在透析前和透析后,测量患者的呼吸功能,同时采...目的探索接受血液透析的终末期肾病(end-stage renal disease,ESRD)患者液体状态和肺功能之间的关系。方法2019年4月~10月,纳入在辽阳市中心医院血液净化中心接受血液透析的ESRD患者54例。在透析前和透析后,测量患者的呼吸功能,同时采用电阻抗分析方法(bioimpedance analysis,BIA)测量患者的水负荷(overhydration,OH)和细胞外液(extracellular water,ECW),并计算2者的百分比(OH/ECW%)。OH/ECW%>7%视为液体超载。结果血液透析后用力肺活量(forced vital capacity,FVC)、FVC占预计量的百分比(forced vital capacity as a percentage of predicted normal value,FVC%)和第1秒的用力呼气容积(forced expiratory volume in one second,FEV_(1))水平显著升高,而OH/ECW%降低(t值分别为2.213、2.389、2.327、15.117,P值分别为0.030、0.019、0.022、<0.001)。透析前共有15例(27.8%)患者发生了液体超载。液体超载组的FVC、FVC%、FEV_(1)、FEV_(1)占预计量的百分比(FEV_(1)as a percentage of predicted normal value,FEV_(1)%)、用力呼出气量为25%~75%肺活量时的平均流量(forced expiratory flow between 25%and 75%of the FVC,FEF_(25-75))、呼出肺活量25%~75%时的用力呼气流量占预计量百分比(forced expiratory flow between 25%and 75%of the FVC as a percentage of predicted normal values,FEF_(25-75)%)、呼气峰值流速(peak expiratory flow rate,PEFR)、呼气峰值流速占预计量的百分比(peak expiratory flow rate as a percentage of predicted normal value,PEFR%)均低于无液体超载组(t值分别为4.740、5.131、4.902、6.226、4.263、3.668、2.904、3.694,P值分别为<0.001、<0.001、<0.001、<0.001、<0.001、<0.001、0.005、<0.001)。透析前OH/ECW%与FVC、FVC%、FEV_(1)、FEV_(1)%、FEF25–75、FEF25–75%、PEFR、PEFR%呈负相关(r值分别为–0.411、–0.530、–0.395、–0.491、–0.307、–0.272、–0.302、–0.425,P值分别为0.002、<0.001、0.003、<0.001、0.024、0.047、0.027、0.001)。多元线性回归分析模型显示,透析展开更多
Traditionally phase angle was the best predictor in BIA for nutrition and survival in dialysis population. We recently showed that normalized bioimpedance indices are a better risk discriminator for dialysis patients ...Traditionally phase angle was the best predictor in BIA for nutrition and survival in dialysis population. We recently showed that normalized bioimpedance indices are a better risk discriminator for dialysis patients and the general popu-lation. We hereby aimed to explore discriminating factors behind them. Methods: We assessed the body capacitive index (BCI = Capacitance × Height2/Weight);body resistive index (BRI = Resistance × Weight/Height2);and also, CH2 (= Capacitance × Height2) which represents total body capacitive volume in physics. We initially performed BIA for 206 female, 116 male healthy volunteers, followed by, prospective study for 128 CAPD patients (47 diabetes mellitus (DM), 81 non-DM;59 male, 69 female) for >2 years. Results: Moderately good negative correlation of albumin and BCI (r = -0.533, p X2 = 165.6), followed by CH2 (X2 = 140), phase angle (X2 = 59.3) and BRI (X2 = 52.2). Thirty five (27.3%) patients died during the study period (Fatal cause: infection (54%), cardiovascular (26%)). In Cox regression, CH2 ( X24 = 32.4) was the best predictor for all-cause mortality, followed by BCI (X24 = 27.7) and phase angle ( X24 = 19.3). Conclusion: The phase angle was a compound parameter of the body capacity index (BCI) and body resistive index (BRI). BCI has a mod-erately good negative correlation with albumin and this supports its role in reflecting the severity of malnutrition in CAPD patients. CH2 represents total nutrition deficit and thus the major risk indicator for the survival of CAPD pa-tients.展开更多
文摘目的探索接受血液透析的终末期肾病(end-stage renal disease,ESRD)患者液体状态和肺功能之间的关系。方法2019年4月~10月,纳入在辽阳市中心医院血液净化中心接受血液透析的ESRD患者54例。在透析前和透析后,测量患者的呼吸功能,同时采用电阻抗分析方法(bioimpedance analysis,BIA)测量患者的水负荷(overhydration,OH)和细胞外液(extracellular water,ECW),并计算2者的百分比(OH/ECW%)。OH/ECW%>7%视为液体超载。结果血液透析后用力肺活量(forced vital capacity,FVC)、FVC占预计量的百分比(forced vital capacity as a percentage of predicted normal value,FVC%)和第1秒的用力呼气容积(forced expiratory volume in one second,FEV_(1))水平显著升高,而OH/ECW%降低(t值分别为2.213、2.389、2.327、15.117,P值分别为0.030、0.019、0.022、<0.001)。透析前共有15例(27.8%)患者发生了液体超载。液体超载组的FVC、FVC%、FEV_(1)、FEV_(1)占预计量的百分比(FEV_(1)as a percentage of predicted normal value,FEV_(1)%)、用力呼出气量为25%~75%肺活量时的平均流量(forced expiratory flow between 25%and 75%of the FVC,FEF_(25-75))、呼出肺活量25%~75%时的用力呼气流量占预计量百分比(forced expiratory flow between 25%and 75%of the FVC as a percentage of predicted normal values,FEF_(25-75)%)、呼气峰值流速(peak expiratory flow rate,PEFR)、呼气峰值流速占预计量的百分比(peak expiratory flow rate as a percentage of predicted normal value,PEFR%)均低于无液体超载组(t值分别为4.740、5.131、4.902、6.226、4.263、3.668、2.904、3.694,P值分别为<0.001、<0.001、<0.001、<0.001、<0.001、<0.001、0.005、<0.001)。透析前OH/ECW%与FVC、FVC%、FEV_(1)、FEV_(1)%、FEF25–75、FEF25–75%、PEFR、PEFR%呈负相关(r值分别为–0.411、–0.530、–0.395、–0.491、–0.307、–0.272、–0.302、–0.425,P值分别为0.002、<0.001、0.003、<0.001、0.024、0.047、0.027、0.001)。多元线性回归分析模型显示,透析
文摘Traditionally phase angle was the best predictor in BIA for nutrition and survival in dialysis population. We recently showed that normalized bioimpedance indices are a better risk discriminator for dialysis patients and the general popu-lation. We hereby aimed to explore discriminating factors behind them. Methods: We assessed the body capacitive index (BCI = Capacitance × Height2/Weight);body resistive index (BRI = Resistance × Weight/Height2);and also, CH2 (= Capacitance × Height2) which represents total body capacitive volume in physics. We initially performed BIA for 206 female, 116 male healthy volunteers, followed by, prospective study for 128 CAPD patients (47 diabetes mellitus (DM), 81 non-DM;59 male, 69 female) for >2 years. Results: Moderately good negative correlation of albumin and BCI (r = -0.533, p X2 = 165.6), followed by CH2 (X2 = 140), phase angle (X2 = 59.3) and BRI (X2 = 52.2). Thirty five (27.3%) patients died during the study period (Fatal cause: infection (54%), cardiovascular (26%)). In Cox regression, CH2 ( X24 = 32.4) was the best predictor for all-cause mortality, followed by BCI (X24 = 27.7) and phase angle ( X24 = 19.3). Conclusion: The phase angle was a compound parameter of the body capacity index (BCI) and body resistive index (BRI). BCI has a mod-erately good negative correlation with albumin and this supports its role in reflecting the severity of malnutrition in CAPD patients. CH2 represents total nutrition deficit and thus the major risk indicator for the survival of CAPD pa-tients.
