【摘要】 目的探讨应用B型钠尿肽(BNP)联合多频生物电阻抗在评估腹膜透析(PD)患者干体重方面的临床价值。方法选择透析龄大于3个月的持续性非卧床腹膜透析(CAPD)患者42例,依据下腔静脉直径/体表面积(VCD)分为达到干体重组和未达到干体重组各21例,选择健康志愿者21名作为正常对照组。使用多频生物电阻抗测定各组患者细胞外液百分比(ECW%)、总体液百分比(TBW%),同时检测血清BNP水平。结果未达到干体重组所测ECW%和TBW%水平较达到干体重组及对照组明显升高,差异有显著统计学意义(P<0.01)。达到干体重组测得ECW%和TBW%水平与对照组相比,差异无统计学意义(P>0.05)。未达到干体重组测得BNP数值较达到干体重组及对照组明显升高,差异有显著统计学意义(P<0.01)。达到干体重组测得BNP数值较对照组升高,差异有显著统计学意义(P<0.01)。结论 BNP可以用来评估PD患者的干体重,但在一定程度上受心功能的影响。生物电阻抗能准确评估PD患者干体重,受性别、体重等影响较大。BNP联合生物电阻抗能简便、准确、快速地评估PD患者的干体重。更多还原

【Abstract】 Objective To evaluate the clinical significance of assessing the dry weight of patients undergoing peritoneal dial-ysis(PD) by the B-type natriuretic peptide(BNP) and multi-frequency bioelectrical impedance analysis. Methods A total of 42 patients treated with continuous ambulatory peritoneal dialysis(CAPD) for more than 3 months were enrolled in this study. The inferi-or vena cava diameter(IVCD) of all participants were measured,and then the values were adjusted by surface area(IVCD/surface area,or VCD),which was deemed as a golden standard of assessing dry weight. All PD patients were divided into 2 groups by the val-ue of VCD:dry weight group and non-dry weight group. Twenty-one healthy volunteers were selected to the control group. Extracel-lular water percentage(ECW%) and total body water percentage(TBW%) of the 3 groups were measured by MBIA. Plasma BNPs of all participants were measured at the same time. Results Both ECW% and TBW% of non-dry weight group were significantly higher than those of the other two groups(P < 0.01),and the differences in ECW% and TBW% between dry weight group and control group were not significant(P > 0.05). The value of serum BNP in non-dry weight group was significantly higher than that of dry weight group and control group(P < 0.01),meanwhile the value of serum BNP in dry weight group was significantly higher than that of control group(P < 0.01). Conclusion BNP and MBIA can be used to assess dry weight in PD patients. But BNP is susceptible to cardiac function and MBIA is affected by sex and weight. A combination of BNP and MBIA will be a simple,correct and rapid method in assessing dry weight of PD patients.更多还原