OCM对血液透析充分性评价研究.docVIP

OCM对血液透析充分性评价研究 　　【摘要】 目的：探讨在线尿素清除率监测（OCM）评估血液透析充分性的可行性和准确性。方法：随机选取规律血液透析患者60例，其中男性32例，女性28例，透析中血流量240～330 ml/min，透析液流量500 ml/min。利用OCM测得Kt/V值，同时透析前后取全血检测尿素氮浓度，根据单室尿素动力模型DaugirdasⅡ公式计算Kt/V值，比较两种方法的相关性及不同体重、超滤量对两者的影响。结果：患者OCM测得的Kt/V值为1.34±0.22，采血法测得的Kt/V值（1.39±0.23），两者有显著性差异（t=2.81，P60 kg两组，其中体重≤60 kg组两种方法测得的Kt/V均高于体重60 kg组。将患者按超滤量分为3.5 kg、≥3.5 kg组。两组Kt/V值无论采用OCM还是采血计算法比较差异有统计学意义（P0.05）。结论：OCM与常规方法测得Kt/V值有较好的相关性，可以在临床广泛使用。 　　【关键词】 血液透析； 透析充分性； 在线尿素清除率监测 　　中图分类号 R459.5 文献标识码 B 文章编号 1674-6805（2015）20-0018-02 　　The Research of Hemodialysis Adequacy Evaluation Using On-line Clearance Monitoring/LI Xiao-rong.//Chinese and Foreign Medical Research，2015，13（20）：18-19 　　【Abstract】 Objective：To investigate the feasibility and accuracy of online clearance monitoring （OCM） in assessing hemodialysis adequacy.Method：Sixty patients with maintenance hemodialysis were investigated on OCM appliance，whose blood flow was 240～330 ml/min，dialysate flow was 500 ml/min.Meanwhile，blood urea nitrogen（BUN） of pre- and post- dialysis were examined and calculate Kt/v according to the equation Daugirdas.Then，the correlation was evaluated between Kt/V by OCM and by calculation.Kt/V by OCM and by calculation was also compared in the situations of different body weight，ultrafiltration volum.Result：Kt/V by OCM was （1.34±0.22），and by calculation was （1.39 ±0.23），the correlation coefficient of linear regression analysis，γ=0.813，（P60 kg），the Kt/V value from OCM was （1.49±0.17） and （1.24±0.19）.The value by calculation was （1.55±0.19） and （1.29±0.19）（P0.05）.The differences either by OCM or by calculation were statistically significant between the patients with ultrafiltration volume 3.5 kg and those ≥3.5 kg.Conclusion：Correlation between Kt/V by OCM and by calculation was satisfactory.OCM could be applied in clinic widely. 　　【Key words】 Hemodialysis； Dialysis adequacy； OCM 　　First-author’s address：Civil Aviation General Hospital Dialysis Center，Beijing 100123，China 　　doi：10.14033/ki.cfmr.2015.20.