血液透析终末期肾病患者的瞬时弹性成像：净液体清除的影响
Transient Elastography in End-Stage Renal Disease Patients on Hemodialysis: The Effect of Net Fluid Withdrawal.
作者信息
Khunpakdee Narongrit, Jayanama Kullapong, Kaewdoung Piyaporn, Promson Kwannapa, Rattanasiri Sasivimol, Warodomwichit Daruneewan, Kantachuvesiri Surasak, Sobhonslidsuk Abhasnee
机构信息
Division of Gastroenterology and Hepatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Blood Purif. 2015;40(3):256-9. doi: 10.1159/000439582. Epub 2015 Oct 3.
BACKGROUND/AIMS: The impact of volume status on liver stiffness measurement (LSM) as measured by transient elastography (TE) as in end-stage renal disease (ESRD) was unclear. We evaluated LSM before and after hemodialysis (HD) and identified the associated factors if the difference of LSM existed.
METHODS
A cross-sectional study was conducted in ESRD patients on regular HD. Subjects underwent TE and bioelectrical impedance before and after HD.
RESULTS
Thirty-six patients were enrolled. Mean (SD) net fluid withdrawal volume (NFWV) per session was 2.55 (0.9) l. Median (range) pre- and post-HD LSMs were 5.38 (2.8-25.7) and 5.4 (2.8-26) kPa, respectively (p = 0.712). Mean differences of pre- and post-HD LSMs correlated with NFWV (r = 0.49, 95% CI 0.19-0.71, p = 0.002).
CONCLUSION
In ESRD on regular HD, LSM is not affected by HD. TE can be done before or after HD with similar results. However, fluid excess at pre-HD can cause inaccurately high LSM.
背景/目的：在终末期肾病（ESRD）中，容量状态对经瞬时弹性成像（TE）测量的肝脏硬度值（LSM）的影响尚不清楚。我们评估了血液透析（HD）前后的LSM，并确定了LSM存在差异时的相关因素。
方法
对接受常规HD的ESRD患者进行了一项横断面研究。受试者在HD前后接受了TE和生物电阻抗检查。
结果
共纳入36例患者。每次透析的平均（标准差）净脱水量（NFWV）为2.55（0.9）升。HD前和HD后的LSM中位数（范围）分别为5.38（2.8 - 25.7）和5.4（2.8 - 26）kPa（p = 0.712）。HD前后LSM的平均差异与NFWV相关（r = 0.49，95%CI 0.19 - 0.71，p = 0.002）。
结论
在接受常规HD的ESRD患者中，LSM不受HD影响。HD前后均可进行TE检查，结果相似。然而，HD前的液体过多可能导致LSM测量值不准确地偏高。
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