Kim Kwang Yoon, Cho Wonjun, Shin Hong Ju
Department of Family Medicine & Health Promotion Center, Myoungju Hospital, Yongin, Republic of Korea.
Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea.
Medicine (Baltimore). 2025 Aug 15;104(33):e44028. doi: 10.1097/MD.0000000000044028.
The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification to describe patients with chronic venous disease (CVD) has limitations in that it cannot be quantitatively evaluated. Thus, we aimed to determine whether measuring changes in extracellular fluid (ECF) can be an objective and quantitative indicator after CVD treatment. In this retrospective, single-center study, changes in ECF and symptoms of CVD were analyzed using bioelectrical impedance analysis at baseline (V0), after 1 month (V1), and after 3 months (V2) between April and November 2023. Subgroup analysis was performed to determine whether sex, body mass index (BMI), baseline CEAP grade, and additional diuretic use could affect further ECF reduction. Compared with V0, ECF in both legs significantly reduced over the intervention period. At V1, compared with V0, significant ECF reduction in the right leg (-0.47%, P = .0085) and left leg (-0.57% and P = .0021) were observed. ECF reduction at V2 was more pronounced compared to 1 month after treatment in the right leg (-0.66%, P = .001) and left leg (-0.71% and P = .0003). Sex, baseline CEAP grade, and additional diuretic use did not affect the difference in the decline of ECF after treatment, but BMI caused significant differences in the degree of ECF reduction after treatment. Changes in ECF evaluated by bioelectrical impedance analysis can be an objective indicator of the treatment effect of chronic venous insufficiency. Diuretic combination with a venoactive drug did not bring additional benefits. The decrease in ECF after CVD treatment was more pronounced in patients with BMI < 23.
用于描述慢性静脉疾病(CVD)患者的临床-病因-解剖-病理生理(CEAP)分类存在局限性,即无法进行定量评估。因此,我们旨在确定测量细胞外液(ECF)的变化是否可以作为CVD治疗后一个客观且定量的指标。在这项回顾性单中心研究中,于2023年4月至11月期间,使用生物电阻抗分析法分析了基线(V0)、1个月后(V1)和3个月后(V2)的ECF变化及CVD症状。进行亚组分析以确定性别、体重指数(BMI)、基线CEAP分级和额外使用利尿剂是否会影响ECF的进一步减少。与V0相比,在干预期间双腿的ECF均显著降低。在V1时,与V0相比,观察到右腿(-0.47%,P = 0.0085)和左腿(-0.57%,P = 0.0021)的ECF显著降低。与治疗1个月后相比,V2时右腿(-0.66%,P = 0.001)和左腿(-0.71%,P = 0.0003)的ECF降低更为明显。性别、基线CEAP分级和额外使用利尿剂并不影响治疗后ECF下降的差异,但BMI导致治疗后ECF减少程度存在显著差异。通过生物电阻抗分析评估的ECF变化可以作为慢性静脉功能不全治疗效果的客观指标。利尿剂与血管活性药物联合使用并未带来额外益处。BMI < 23的患者在CVD治疗后ECF的降低更为明显。