- 期刊
- OpenAccess
在線尿素清除指數測定的臨床應用
The application value of two different online monitoring system in evaluating Kt/V of hemodialysis patients
摘要
目的：探討本院兩種透析機在線尿素清除指數（Kt/V）的監測情況，評估其監測Kt/V的可行性，準確性以及在血液透析中的應用價值。方法：利用Gambro透析機以及Dialog透析機在線監測血液透析患者的Kt/V值（online Kt/V）；同時抽血檢測血液透析患者前後尿素氮濃度，根據Daugirdas公式計算Kt/V值（spKt/V）作為對照。結果：232例血液透析患者，利用Gambro透析機進行血液透析，測得平均值（online Kt/V）為1.25±1.37；根據Daugirdas公式計算平均值（spKt/V）為1.65±0.31，相關性分析顯示：（r=0.676,P<0.001）。在線測得值（online Kt/V）明顯小於抽血計算值（spKt/V）（P<0.05）；而校正後的（adjusted Kt/V）為1.62±0.59，與抽血計算的（spKt/V）值基本接近，相關性分析顯示：（r=0.946,P<0.001）。293例血液透析患者，利用Dialog透析（不提供校正系統）機監測患者的online Kt/V值（1.82±1.27），高於常規抽血方法所得的spKt/V值（1.69±0.37），相關性分析顯示：兩者存在顯著的相關性（r=0.765,P<0.001）。結論：Gambro透析機Diascan監測系統online Kt/V值偏低，校正後Kt/V值卻吻合度好，相關性較好：而Dialog透析機在線檢測值稍高於Kt/V，注意二者的差別，保證患者血液透析的充分性。
並列摘要
Objective. To investigate the feasibility and accuracy of two different dialysis machines monitoring systems in assessing the Kt/V value of hemodialysis adequacy during hemodialysis. Methods. Kt/V values of patients with maintenance hemodialysis were assessed by the monitoring system of Gambro machine and Dialog machine. Meanwhile, blood urea nitrogen (BUN) of pre- and post- dialysis were examined, and the Kt/ V values were calculated according to the Daugirdas formula. The correlation between Kt/ V shown by the monitoring systems and by calculation was studied. Results. The mean value of online Kt/V of 232 hemodialysis patients by Gambro machine (1.25±1.37) was lower than the mean value of spKt/V by calculation (1.65±0.31), and correlation between online Kt/ V and spKt/V was relatively satisfactory (r=0.676, P<0.001). However, there was no significant difference between the spKt/V (1.65±0.31) and adjusted Kt/V (1.62±0.59). The value of Kt/V of 232 hemodialysis patients by Dialog machine (1.82±1.27) was higher than the value of spKt/V by calculation (1.69±0.37), and correlation between Kt/ V by Dialog machine and by calculation was satisfactory (r=0.765, P<0.001). Conclusion. Online Kt/V values by Gambro machine are usually lower than spKt/V calculated by Formula from urea measurements. However, correlation between adjusted Kt/V by Gambro machine and spKt/V by calculation was very satisfactory. Kt/V values by Dialog machine (No adjusting system provided) are usually a little higher than those calculated from urea measurements by Daugirdas formula. This difference has to be considered in application of the results in clinical practice.