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Adimea系统对维持性血液透析患者透析充分性的评价

  

  • 出版日期:2020-10-28 发布日期:2020-10-30

Evaluation of dialysis adequacy by Adimea system in maintenance hemodialysis patients

  • Online:2020-10-28 Published:2020-10-30

摘要: 目的:探讨Adimea系统在评价维持性血液透析患者透析充分性的应用价值。方法:检测上海交通大学医学院附属瑞金医院血液净化中心167例维持性血液透析患者通过采血法及Adimea系统监测获得的单室尿素清除指数(spKt/V),通过线性相关分析了解两者的相关性,通过多元线性回归分析了解Adimea系统监测尿素清除率的临床影响因素,并比较spKt/V值达标与未达标患者的临床资料。结果:(1)Adimea系统监测spKt/V(147±027),采血法spKt/V(147±026),直线相关分析显示,两者具有良好的相关性(r=0697,P<0001)。(2)干体重、前白蛋白、体重增长率、尿酸、透析前尿素氮是Adimea测定spKt/V值的独立影响因素,其中干体重(OR=0587,P<0001)、透前尿素氮(OR=0855,P=0015)为负相关,前白蛋白(OR=1300,P<0001)、体重增长率(OR=1240,P=0001)、尿酸(OR=1206,P=0003)为正相关。(3)spKt/VAdimea达标组和未达标组在性别、尿素下降率(URR)、透前体重、干体重等方面存在显著差异,实验室指标无明显差异。结论:Adimea系统监测spKt/V值与采血法spKt/V值具有显著相关性,可应用于实时在线监测尿素清除指数,是临床评价透析充分性的可靠指标。

关键词: 血液透析, 透析充分性, 单室尿素清除指数, Adimea系统

Abstract: Objective:To explore the relationship between  dialysis adequacy measured by Adimea system and spKt/V by caculation.Methodology:spKt/V values by Adimea and by calculation from 167 maintenance hemodialysis patients were measured.The correlation between them was analyzed by correlation assay.And  clinical factors which affect  values of spKt/V by Adimea were analyzed by multiple linear regression.Results:spKt/V value by Adimea and by calculation was (147±027) and (147±026),respectively,and the correlation coefficient was 0697 (P<0001).Dry body weight,prealbumin,urea predialysis,growth rate of body weight and uric acid were independent factors of spKt/V by Adimea.According to whether spKt/V by Adimea was more than 12,the patients were divided into two groups.The gender,urea reduction ratio,dry body weight,predialysis body weight were significantly different between the two groups.Conclusion:spKt/V by Adimea is significantly related with that by calculation,which is affected by dry body weight,prealbumin,urea predialysis,growth rate of body weight and uric acid.Adimea system can be used as a reliable indicator of  dialysis adequacy.