天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (11): 1381-1383.doi: 10.11958/20160381

• 临床研究 • 上一篇    下一篇

透析频率和间期对 Kt/V 的影响

朱慧敏 1， 赵新菊 2， 左力 2△   

  1. 1 天津市第五中心医院肾内科 （邮编 300450）； 2 北京大学人民医院肾内科
  • 收稿日期:2016-05-03 修回日期:2016-09-19 出版日期:2016-11-15 发布日期:2016-11-15
  • 通讯作者: △通讯作者 E-mail： zuoli@bjmu.edu.cn E-mail:zuoli@bjmu.edu.cn
  • 作者简介:朱慧敏 （1979）， 女， 主治医师， 硕士， 主要从事肾小球病、 血液净化研究

The influence of dialysis frequency and interval on calculation of Kt/V

ZHU Huimin1, ZHAO Xinju2, ZUO Li2△   

  1. 1 Department of Nephrology, the Fifth Central Hospital of Tianjin, Tianjin 300450, China; 2 Department of Nephrology, Peking University People’ s Hospital
  • Received:2016-05-03 Revised:2016-09-19 Published:2016-11-15 Online:2016-11-15
  • Contact: △Corresponding Author E-mail: zuoli@bjmu.edu.cn E-mail:zuoli@bjmu.edu.cn

PDF (PC)

4022

摘要： 目的 比较修订尿素产生因子 （GFAC） 对单室尿素清除指数 （spKt/V） 以及由此计算的平衡 Kt/V （eKt/V） 和 标准 Kt/V（stdKt/V）的影响。方法 选取在北京大学人民医院行维持性血液透析， 但透析次数非每周 3 次或虽是每 周 3 次但非相隔 2 d 采血的患者 95 例。以日常工作中使用的 0.008 为 GFAC 计算 spKt/V1、 eKt/V1 和 stdKt/V1； 再用 根据透析频率及透析间期修订的 GFAC 值计算 spKt/V2、 eKt/V2、 stdKt/V2； 将 spKt/V1、 eKt/V1、 stdKt/V1 分别与 spKt/ V2、 eKt/V2、 stdKt/V2 进行比较。结果 spKt/V1 与 spKt/V2（1.538±0.357 vs. 1.504±0.341）， eKt/V1 与 eKt/V2（1.525± 0.315 vs. 1.495±0.301）， stdKt/V1 与 stdKt/V2（2.298±0.230 vs. 2.279±0.230）比较差异均有统计学意义（P＜0.01）。结 论 将 GFAC=0.008 用于不符合尿素动力学模型要求的患者会高估透析充分性， 应根据不同透析频率和采血时间使 用不同的 GFAC 值， 以更准确估计 spKt/V、 eKt/V 及 stdKt/V。

关键词: 肾透析, 尿素产生因子, 单室 Kt/V, 平衡 Kt/V, 标准 Kt/V

Abstract: Objective To compare the influence of the urea generation factor (GFAC) modification on spKt/V, balanced Kt/V (eKt/V) and standardized Kt/V (stdKt/V), where eKt/V and stdKt/V were estimated from spKt/V. Methods Ninety- five hemodialysis patients who were dialyzed except three times per week or not 2- day preceding interdialysis interval for 3/week from the Peking University People's Hospital were included in this study. The value of spKt/V1 was estimated using GFAC=0.008, and eKt/V1 and stdKt/V1 were estimated. Using modified GFAC, spKt/V2, eKt/V2 and stdKt/ V2 were estimated. The spKt/V1, eKt/V1 and stdKt/V1 were compared with spKt/V2, eKt/V2 and stdKt/V2. Results There were significant differences between spKt/V1 and spKt/V2 (1.538±0.357 vs. 1.504±0.341), eKt/V1 and eKt/V2 (1.525±0.315 vs. 1.495±0.301), stdKt/V1 and stdKt/V2 (2.298±0.230 vs. 2.279±0.230), respectively (P<0.01). Conclusion Using GFAC= 0.008 in equation for patients who were not matched the urea kinetic model could overestimate spKt/V, and hence, using the modified GFAC based on the dialysis schedules and the day of blood drawn can be more accurately to estimate the spKt/V, eKt/V and stdKt/V.

Key words: renal dialysis, urea generation factor, single-pool Kt/V, equilibrated Kt/V, standard Kt/V