| Objectives:By applied bio-impedance electrical spectroscopy(BIS) to compare the body fluid distribution between normal volunteers and maintenance hemodialysis patients. And the changes of body fluid distribution during dialysis within a short time. Attempt to explore the correlation between the Pre-ECV/ICV ratio(Extracellular fluid and Intracellular fluid ratio) and CTR(Cardiac thoracic Rate),and the significance in clinic in assessing dry weight (DW) in stable hemodialysis patients.Methods:Fifty-five stable HD patients who had been on HD for more than 3 months in our hospital were selected as the observation group, among them the male 24 examples and female 31 examples. Chest X-ray were screened before dialysis, calculated the CTR. ECV, ICV were measured by bioelectrical impedance spectroscopy calculated the percentage of weight respectively (ECV%,ICV%) and the ECV/ICV ratio. ECV,ICV, ECV%,ICV% and ECV/ICV ratio were measured and calculated before and after dialysis. Fifty-four healthy volunteers were enrolled in the control group, the male 26 examples and female 28 examples, measure weight; ECV,ICV were measured by bioelectrical impedance spectroscopy, calculated the percentage of weight respectively and the ECV/ICV ratio. Find the difference of ECV%,ICV%å’ŒECV/ICV ratio between the observation group and the control group. Detect the changes of ECV,ICV,ECV%,ICV% and ECV/ICV ratio before and after dialysis; Analysis the relevance of pre-dialysis ECV/ICV ratio and CTR which taken on the day before dialysis. Analysis the relevance of the level of body fluid distribution with dialysis adequacy and Alb, Hb level of HD patients. The measurement was conducted by BCA- 1B body composition analyzer.Results:1. Comparison of the female and male of "the control group" and "the observation group":ECV% and ICV% have significant difference (P<0.01)2.Both male and female, the pre-HD ECV%and ECV/ICV ratio were significantly higher than those of normal controls (P<0.01), but comparison of "the observation group" and "the control group":ICV% has no significant difference (P>0.05). The post-HD ECV%,ICV% and ECV/ICV ratio have no significant difference (P>0.05)3.By analyzed with paired-samples T-Test, in MHD patients, a significant decrease of ECV%, ECV/ICV ratio were seen post-HD (P<0.01). But ICV% has no significant difference (P>0.05)4.A significant negative correlation was observed between Pre-ECV/ICV ratio and CTR. Pearson r=-0.629, p=0.000.5.There are no significant correlation between ECV, ICV, ECV/ICV ratio and Kt/V (P>0.05)6.There are significant correlation between Hb level of HD patients and Post-ECV, Post-ICV, Pre-ICV(P<0.01); Pre-ECV (P<0.05). But have no significant correlation between Alb level of HD patients and Post-ECV, Post-ICV, Post-ECV/ICV ratio (P>0.05)Conclusions:The body fluid distribution of Patients on maintenance hemodialysis have obvious different from normal controls, mainly the increase in total body water, both extracellular fluid volume and Intracellular fluid volume, roughly equal increments. Dialysis remove excess water, include ECV and ICV, and ECV% is to assess the changes in volume load of MHD patients with a more sensitive indicator. The conversion between ECV% and ICV% may be associated with nutritional status of patients. There are well correlation between Pre-E/I ratio and CTR, which can used for clinical assessment of dry-weight of HD patients. MHD patients with the increase in Extracellular fluid volume and in Intracellular fluid volume(poor control of dry weight) seriously affect the adequacy of dialysis. |
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