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肺部超声与其他容量测定方法在腹膜透析患者中的比较。

Comparison of lung ultrasound and other volumetric methods in peritoneal dialysis patients.

机构信息

Nephrology Department, Sisli Hamidiye Etfal Training and Research Hospital.

Nephrology Department, Basaksehir Cam and Sakura City Hospital.

出版信息

Medicine (Baltimore). 2021 Jan 22;100(3):e23856. doi: 10.1097/MD.0000000000023856.

DOI:10.1097/MD.0000000000023856
PMID:33545952
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7837871/
Abstract

Although many alternative methods are present, maintaining ideal volume status in peritoneal dialysis (PD) patients still rely on clinical evaluation due to lack of an evidence-based method. Lung ultrasound (LUS) is a new method for evaluation of hidden congestion in this group.LUS findings and its relationship with other volumetric methods are investigated in this observational cross-sectional study.In this observational cross sectional study, LUS was performed to all PD patients and compared with symptoms of hypervolemia, physical examination, vascular endothelial growth factor-C (VEGF-C), and N-terminal pro-brain natriuretic peptide levels, chest radiography, echocardiography, bioelectrical impedance analysis.Data of 21 PD patients were evaluated. There was correlation between number of B lines and VEGF-C levels (r = 0.447, P = .042), daily urine output (r = 0.582, P = .007) and left ventricle mass index (r = -0.456, P = .038). Correlations with all other parameters were not significant. Daily urine output and VEGF-C levels were significantly different when B lines were grouped into 2 according to the median level (P < .05 for all).This is the widest spectrum study looking for LUS findings and other volumetric parameters in a small PD cohort. LUS might be useful to evaluate hidden hypervolemia. Its correlation with VEGF-C level is a novel finding.

摘要

尽管存在许多替代方法,但由于缺乏基于证据的方法,腹膜透析(PD)患者仍依赖临床评估来维持理想的容量状态。肺部超声(LUS)是评估该人群隐性充血的新方法。本观察性横断面研究调查了 LUS 结果及其与其他容积方法的关系。在这项观察性横断面研究中,对所有 PD 患者进行了 LUS 检查,并将其与充血症状、体格检查、血管内皮生长因子-C(VEGF-C)和 N 端脑利钠肽前体水平、胸部 X 线、超声心动图、生物电阻抗分析进行了比较。评估了 21 名 PD 患者的数据。B 线数量与 VEGF-C 水平(r=0.447,P=0.042)、每日尿量(r=0.582,P=0.007)和左心室质量指数(r=-0.456,P=0.038)之间存在相关性。与所有其他参数的相关性不显著。根据中位数水平将 B 线分为 2 组时,每日尿量和 VEGF-C 水平有显著差异(所有 P<0.05)。这是一项范围最广的研究,旨在观察小 PD 队列中 LUS 结果和其他容积参数。LUS 可能有助于评估隐性充血。其与 VEGF-C 水平的相关性是一个新发现。

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本文引用的文献

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Am J Kidney Dis. 2018 Mar;71(3):412-422. doi: 10.1053/j.ajkd.2017.10.009. Epub 2017 Dec 21.
2
Value of bioimpedance analysis estimated "dry weight" in maintenance dialysis patients: a systematic review and meta-analysis.生物电阻抗分析估算维持性透析患者“干体重”的价值:一项系统评价和荟萃分析。
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Serum VEGF-C levels as a candidate biomarker of hypervolemia in chronic kidney disease.血清血管内皮生长因子C水平作为慢性肾脏病高血容量的候选生物标志物。
Medicine (Baltimore). 2017 May;96(18):e6543. doi: 10.1097/MD.0000000000006543.
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Kidney Int. 2017 May;91(5):1214-1223. doi: 10.1016/j.kint.2016.12.008. Epub 2017 Feb 13.
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N‑terminal pro‑B-type natriuretic peptide as a marker of hypervolemia and predictor of increased mortality in patients on hemodialysis.N端前B型钠尿肽作为血液透析患者血容量过多的标志物及死亡率增加的预测指标。
Pol Arch Med Wewn. 2015;125(7-8):560-9. doi: 10.20452/pamw.2969. Epub 2015 Jul 3.
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Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.成人经超声心动图进行心腔定量的建议:美国超声心动图学会和欧洲心血管影像学会的更新版
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7
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