摘要
目的探讨在线尿素清除率监测(OCM)在评价血液透析充分性中的价值。方法36例在本中心行维持性血液透析的终末期肾衰患者,采用OCM仪检测尿素清除指数(K t/V),同时在透前、透后抽血,应用尿素动力学———室可变容积模型检测K t/V计算值,对OCM检测值和K t/V计算值进行比较并进行相关性分析;对其中15例透析器复用前后的K t/V比较,探讨OCM在评价血液透析充分性中的作用。结果透析器首次使用时,患者OCM检测值与K t/V计算值相比有显著差异(1.27±0.23vs1.53±0.30,P<0.001),相关性分析显示两者存在显著的直线相关性(P<0.001);透析器首次使用和复用时,患者的OCM检测值和K t/V计算值相比,亦具有显著差异(1.31±0.22vs1.55±0.30,P<0.001)。透析器复用的15例患者中,首次使用与复用第3次和第5次相比,OCM检测值及K t/V计算值均无显著差异(P>0.05)。透析每周2次与3次患者的单次血透OCM检测值及K t/V计算值相比无显著差异(P>0.05)。结论OCM检测值低于应用尿素动力学———室可变容积模型计算的K t/v值,二者呈显著正相关,可以作为评价尿毒症血透患者血液透析充分性的一项较可靠指标。
Objective To evaluate the adequacy of hemodialysis by online clearance monitoring（OCM） in hemodialysis patients. Methods The Kt/V values of 36 maintenance hemodialysis patients in our center who were assessed by both OCM and single-pool urea kinetic model were compared, and the Kt/V values of patients in the firstuse dialyser and the reused dialyser were also compared. Results In the patients who used a new dialyser,Kt/V values were 1.27±0.23 measured by OCM ,whereas 1.53±0.30 by single-pool urea kinetic model（ r = 0. 574, P 〈 0. 001）. In the patients who used new dialysers and reused dialysers, Kt/V values measured by OCM and single-pool urea kinetic model also showed significant differences（ 1.31±0.22 vs 1.55±0.30,P 〈0. 001 ）. In the fifteen patients who applied the first, third and fifth time-used dialyser,Kt/V measured by OCM and by model had no significant differences（P 〉 0.05）. In all the patients undergoing dialysis two or three times per week, Kt/V measured by OCM and by model also showed no differences （P 〉 0.05）. Conclusion During hemodialysis, the OCM option provides an accurate tool for continuous online monitoring of urea clearance.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第5期532-534,共3页
Journal of Shanghai Jiao tong University:Medical Science
