Cabré E, de León R, Planas R, Bertrán X, Domènech E, Gassull M A
Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona.
Gastroenterol Hepatol. 1995 Aug-Sep;18(7):359-65.
Bioelectric impedance analysis (BIA) was carried out in 55 cirrhotic patients (32 with and 23 without ascites) and 20 healthy controls with the aim of evaluating its usefulness in cirrhosis. Furthermore, in 13 of the ascitic patients BIA was performed immediately before and 24 hours after paracentesis. No differences were observed among the three groups in either resistance or the values of total body water (TBW), lean body mass (LBM) and fatty body mass (FBM) estimated by BIA. On the other hand, reactance and the phase angle were lower in cirrhotic patients. Likewise, the percentage of body cell mass (BCM) was lower in ascitic patients than in the non ascitic patients and the controls (37.7 +/- 1.2 vs 42.3 +/- 1.2 vs 45.5 +/- 1.6%; p = 0.0003). Mid-arm muscle circumference was correlated with TBW and LBM in all the groups and with only BCM in the controls and those without ascites. In general, the precision of the regression lines was lower in the ascitic patients than in the non ascitic patients and controls. TBW decreased following paracentesis (28.3 +/- 1.7 vs 30.3 +/- 2.0 kg; p = 0.008) but this decrease did not correspond with the volume of ascitic fluid obtained in any case. The mean BCM did not change with paracentesis although individual differences ranged between -8.0 and +11.2% (CI 95%). It is concluded that BIA is not a reliable method for nutrition evaluation in cirrhotic patients with ascites in clinical practice and that the anthropometric parameters are still preferable in these cases.
对55例肝硬化患者（32例有腹水，23例无腹水）和20例健康对照者进行生物电阻抗分析（BIA），目的是评估其在肝硬化中的应用价值。此外，对13例腹水患者在腹腔穿刺术前和术后24小时立即进行BIA。三组在电阻或通过BIA估计的总体水（TBW）、瘦体重（LBM）和脂肪体重（FBM）值方面均未观察到差异。另一方面，肝硬化患者的电抗和相角较低。同样，腹水患者的体细胞质量（BCM）百分比低于非腹水患者和对照组（37.7±1.2 vs 42.3±1.2 vs 45.5±1.6%；p = 0.0003）。所有组的上臂中部肌肉周长与TBW和LBM相关，而仅对照组和无腹水患者的上臂中部肌肉周长与BCM相关。一般来说，腹水患者回归线的精度低于非腹水患者和对照组。腹腔穿刺术后TBW下降（28.3±1.7 vs 30.3±2.0 kg；p = 0.008），但这种下降在任何情况下都与获得的腹水量不对应。尽管个体差异在-8.0%至+11.2%（95%CI）之间，但平均BCM在腹腔穿刺术后没有变化。结论是，在临床实践中，BIA不是评估肝硬化腹水患者营养状况的可靠方法，在这些情况下，人体测量参数仍然更可取。
