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年龄和血压对使用全身及小腿生物电阻抗技术测定普通人群正常体液状态的影响。

Effect of age and blood pressure on determination of normal fluid status in a general population using whole body and calf bioimpedance techniques.

作者信息

Zhu Fansan, Abbas Samer R, Kotanko Peter, Levin Nathan W

出版信息

Physiol Meas. 2017 Jun;38(6):1289-1300. doi: 10.1088/1361-6579/aa6912.

Abstract

Normal fluid status (dry weight) can be identified by hydration markers established in the healthy population. The general population average could be influenced by age with its accompanying physiological changes and/or illness. The aims of this study were (1) to evaluate the effect of age and systolic blood pressure (SBP) on these markers; (2) to compare mean values of hydration markers as assessed by different bioimpedance techniques. Subjects from the general population (n  =  212, males 105, 57.1% White, 31.6% Black, and 11.3% others) were studied. Body weight, height and SBP were measured. Whole body and calf bioimpedance (Hydra 4200) methods were utilized with subjects in the supine position. Calf normalized resistivity (CNR), fluid overload (FO), extracellular (ECV) and intracellular (ICV) volume measurements ECV/total body water (TBW) were calculated. Subjects were stratified by age; young (Group1): 18-35 years; middle (Group2): 36-60 years, senior (Group3): 61-80 years. Body mass index (BMI), CNR, and ECV/TBW differed significantly between age groups, and genders. ECV and FO increased with age in males. Decreased CNR (indicating relative increased fluid load) (p  <  0.001) and increased SBP (p  <  0.001) were associated with age in all three groups. CNR in Group1 was the same as in 36.0% of subjects in Group2 and 12.5% of subjects in Group3. In those subjects in Group2 and Group3, with CNR levels comparable to Group1 subjects, SBP was lower than in their peers in each respective age group. In conclusion average CNR in Group1 represents the range of healthy subjects. Since CNR is correlated with age, subjects in Group2 and Group3 are more likely to have fluid overload. Although about a third of subjects in Group2 and Group3 were in the range of Group1, the age and associated factors should be considered when CNR is used to identify fluid status in senior patients.

摘要

正常的液体状态(干体重)可通过健康人群中确立的水化指标来识别。一般人群的平均水平可能会受到年龄及其伴随的生理变化和/或疾病的影响。本研究的目的是:(1)评估年龄和收缩压(SBP)对这些指标的影响;(2)比较不同生物电阻抗技术评估的水化指标的平均值。对来自一般人群的受试者(n = 212,男性105名,57.1%为白人,31.6%为黑人,11.3%为其他种族)进行了研究。测量了体重、身高和SBP。受试者仰卧位时采用全身和小腿生物电阻抗(Hydra 4200)方法。计算小腿归一化电阻率(CNR)、液体超负荷(FO)、细胞外(ECV)和细胞内(ICV)体积测量值ECV/总体水(TBW)。受试者按年龄分层;年轻组(第1组):18 - 35岁;中年组(第2组):36 - 60岁,老年组(第3组):61 - 80岁。年龄组和性别之间的体重指数(BMI)、CNR和ECV/TBW存在显著差异。男性的ECV和FO随年龄增加。所有三组中,CNR降低(表明相对液体负荷增加)(p < 0.001)和SBP升高(p < 0.001)均与年龄相关。第1组中的CNR与第2组中36.0%的受试者以及第3组中12.5%的受试者相同。在第2组和第3组中,CNR水平与第1组受试者相当的那些受试者中,SBP低于各自年龄组中的同龄人。总之,第1组的平均CNR代表健康受试者的范围。由于CNR与年龄相关,第2组和第3组的受试者更有可能出现液体超负荷。尽管第2组和第3组中约三分之一的受试者处于第1组的范围内,但在使用CNR识别老年患者的液体状态时,应考虑年龄及相关因素。

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