Park Jongha, Chung Hyun Chul, Kim Min Soo, Kim Shin-Jae, Chang Jai Won, Lee Jong Soo
Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Blood Purif. 2009;28(1):61-8. doi: 10.1159/000210663. Epub 2009 Apr 4.
BACKGROUND/AIMS: The ratio of extracellular water to total body water (ECW/TBW) estimated by bioimpedance spectroscopy (BIS) may be a useful volume index in haemodialysis (HD) patients, but its direct relation to cardiovascular (CV) outcomes has been rarely evaluated.
We investigated the relationship between ECW/TBW by BIS and cardiac troponin T (cTnT) level, a biochemical surrogate of CV mortality.
Seventy-four HD patients without ischemic heart disease (age 51.6 +/- 13.2 years; male:female ratio 36:38; diabetes 37.8%) were recruited. Post-HD ECW/TBW was positively correlated to log cTnT levels (r = 0.60, p < 0.01). In multivariate regression models, male sex (beta = 0.23, p = 0.03), diabetes mellitus (beta = 0.21, p = 0.04), log high-sensitivity C-reactive protein (beta = 0.21, p = 0.04) and post-HD ECW/TBW (beta = 0.37, p < 0.01) were independent risk factors for elevated log cTnT levels.
Post-HD ECW/TBW by BIS is worthy of further evaluation as a pathophysiological index for reducing CV mortality in HD patients.
背景/目的：通过生物电阻抗光谱法（BIS）估算的细胞外液与总体液之比（ECW/TBW）可能是血液透析（HD）患者有用的容量指标，但其与心血管（CV）结局的直接关系鲜有评估。
我们研究了通过BIS测得的ECW/TBW与心肌肌钙蛋白T（cTnT）水平之间的关系，cTnT水平是CV死亡率的生化替代指标。
招募了74例无缺血性心脏病的HD患者（年龄51.6±13.2岁；男女比例为36:38；糖尿病患者占37.8%）。HD后ECW/TBW与cTnT水平的对数呈正相关（r = 0.60，p < 0.01）。在多变量回归模型中，男性（β = 0.23，p = 0.03）、糖尿病（β = 0.21，p = 0.04）、高敏C反应蛋白对数（β = 0.21，p = 0.04）和HD后ECW/TBW（β = 0.37，p < 0.01）是cTnT水平升高的独立危险因素。
通过BIS测得的HD后ECW/TBW作为降低HD患者CV死亡率的病理生理指标值得进一步评估。
