Nakazato S
Nihon Jinzo Gakkai Shi. 1989 Jan;31(1):1-13.
Total body water was measured by means of dilution technic with 99.8% deuterium oxide administration in normal subjects (controls), nephrotic (NS) patients with or without edema, and in longterm hemodialysis (HD) patients. Lean body mass (LBM) was calculated from height, body weight, and waist girth. Body fluid was evaluated according to the TBW/LBM ratio in HD patients. Effect of volume of body fluid on blood pressure was also investigated. Relationship among cardio-thoracic ratio (CTR), standard body weight (SW), and TBW were examined. SWTBW calculated from TBW and LBM, and SWCTR estimated mainly from CTR, blood pressure, were compared. The total body water to body weight ratios (TBW/BW) in controls, NS, and HD patients were 61.2 +/- 1.2%, 71.3 +/- 3.7% (with edema), 60.9 +/- 6.4% (without edema), 64.5 +/- 6.9% (pre-HD), 62.6 +/- 6.6% (post-HD) respectively. The mean TBW/BW of NS patients with edema was significantly greater than those of control, NS patients without edema, and post-HD patients. The TBM/LBM value above 0.78 was suggestive of overhydrated state in HD patients. The mean TBW/LBM in HD patients was 0.757, which was greater than that of controls. Hypotension during HD was seemingly induced by excess ultrafiltration regardless of the value of TBW/LBM. No relationship among CTR, SW, and TBW was observed in HD patients, but the mean TBW/LBM of patients with the CTR exceeding 55% was 0.786, which suggested as overhydrated state. It is useful to determine TBW/BW and TBW/LBM in order to evaluate of volume changes in body fluid of longterm HD patients.
采用稀释技术，通过给正常受试者（对照组）、有或无水肿的肾病综合征（NS）患者以及长期血液透析（HD）患者输注99.8%的氧化氘来测量总体水含量。根据身高、体重和腰围计算瘦体重（LBM）。根据HD患者的总体水/瘦体重比值评估体液情况。还研究了体液量对血压的影响。检查了心胸比率（CTR）、标准体重（SW）和总体水之间的关系。比较了根据总体水和瘦体重计算出的SWTBW以及主要根据CTR、血压估算出的SWCTR。对照组、NS患者以及HD患者的总体水与体重比值（TBW/BW）分别为61.2±1.2%、71.3±3.7%（有水肿）、60.9±6.4%（无水肿）、64.5±6.9%（透析前）、62.6±6.6%（透析后）。有水肿的NS患者的平均TBW/BW显著高于对照组、无水肿的NS患者以及透析后的患者。HD患者中，TBM/LBM值高于0.78提示存在水过多状态。HD患者的平均TBW/LBM为0.757，高于对照组。HD期间的低血压似乎是由过度超滤引起的，而与TBW/LBM值无关。HD患者中未观察到CTR、SW和总体水之间的关系，但CTR超过55%的患者的平均TBW/LBM为0.786，提示存在水过多状态。测定TBW/BW和TBW/LBM有助于评估长期HD患者的体液量变化。
