【摘要】 目的探讨在线清除监测(on-line clearance monitor,OCM)评价血液透析充分性的临床实用价值。方法80例维持性血液透析患者同时应用OCM和常规取血法测定尿素清除指数(Kt/V),对两者的相关性进行评价。结果OCM测定的Kt/V(Kt/Vm)=1.18±0.25,取血法计算的Kt/V(Kt/Vc)=1.45±0.19,二者相关性良好(r=0.942,P<0.001)。同一患者的Kt/Vm较Kt/Vc低0.19±0.11(P<0.001)。Kt/Vc与身高及干体重负相关(r=-0.533和-0.485,P<0.001),与透析超滤量正相关(r=0.331,P=0.008)。通过OCM调整透析处方,短期内即可纠正透析剂量不足。结论应用OCM测定Kt/V,可即时、方便、准确地反映尿素清除效率,有利于分析透析剂量不足的原因并及时调整透析处方,很有临床实用价值。更多还原

【Abstract】 Objective To investigate the value of on-line clearance monitor(OCM) in evaluating dialysis adequacy of hemodialysis patients.Methods In 80 hemodialysis patients,Kt/V was determined by OCM(Kt/Vm) and conventional calculated method on kinetic models(Kt/Vc) at the same time.Results (1) Kt/Vm detected by OCM was 1.18±0.25,which was close correlated with Kt/Vc (r=0.942,P<0.001).(2) Kt/Vc was also correlated with the height and dry weight of patients and the ultrafiltration volume(r=-0.533,-0.485 and 0.331,P<0.01).(3) The prescription of dialysis was adjusted based on the results of OCM and adequate dialysis was achieved in several sessions.Conclusion OCM can display the Kt/V data rapidly,timely and accurately.It is very useful in monitoring the adequacy of dialysis and helping doctors to achieve the optimal prescription as soon as possible.更多还原