摘要：目的评价联机尿素监测仪(UM)在临床使用中的准确性和有效性。方法使用UM监测了17例规律血液透析患者的尿素清除率(Kt／V)、标准蛋白分解率(Npcr)、溶质清除指数(SRI)、尿素清除总量(REM)及尿素分布容积(V)。结果UM测得的REM与透析液定量法(DDQ)相比，差异无显著意义。与传统尿素动力模型(UKM)计算结果相比，UM测得的Kt／V及Npcr差别亦无显著意义。12例患者使用UM连续监测3次透析，每次透析的Kt／V和Npcr相对恒定，但REM及透析前BUN逐次下降。结论与传统UKM相比，UM可提供更准确的透析充分性指标。

Evaluation of the clinical validation and efficiency of on-line urea monitor

LI li ,LI Xuewang ,LIU Hong,et al.

(Division of Nephrology,Peking Union Medical College Hospital,Beijing 100730,China)

Abstract：Objective To evaluate the clinical validation and efficiency of on-line urea monitor.Methods Quantitative parameters (Kt/V,nPCR,REM,SRI and V) were evaluated with on-line urea monitor in 17 patients treated by hemodialysis.Results The paired analysis of urea removed (REM),as estimated by the urea monitor compared with the direct dialysis quantification (DDQ),showed no significant difference.Similarly,compared with urea kinetic model,measurements of Kt/V and nPCR by urea monitor showed no significant difference.When assessed over 1 week in a subgroup of 12 patients,Kt/V and nPCR remained relatively stable during 3 consecutive assessments,but urea removed and predialysis urea concentrations declined.Conclusion Compared with urea kinetic model,on-line urea monitor can give more accurate parameters of dialysis adequacy.

Keywords：Hemodialysis,utilizing;Kinetics,urea;Dialysate;Protein catabolic rate

参考文献：

［1］Lowrie EG,Laird NM.The National Dialysis Cooperative Study.Kidney Int,1983,23 Suppl 13:S1-S122.

［2］Daugirdas JT.Second generation logarithmic estimates of single-pool variable volume kt/V:an analysis of error.J Am Soc Nephrol,1993,4:1199-1204.

［3］Garred LJ,Bariehello DL,Canaud BC.et al.Simple equations for protein catabolic rate determination from pre dialysis and post dialysis blood urea nitrogen.ASAIO,1995,41:889-895.

［4］Watson PE,Watson ID,Batt RD.Total body water volumes for adult males and females estimated from simple antropometric measurements.Am J Clin Nutr,1980,33:27-39.

［5］Bosticardo GM,Avalle U,Giacehino F,et al.Accuracy of an on-line urea monitor compared with urea kinetic model and direct dialysis quantification.ASAIO,1994,40:M426-M431.

［6］Depner TA,Deshaviah PR,Ebben JP,et al.Multicenter clinical validation of an on-line monitor of dialysis adequacy.J Am Soc Nephrol,1996,7:464-471.

［7］Canaud B,Bose JY,Leblanc M,et al.Evaluation of high-flux hemodilafiltration efficiency using an on-line urea monitor.Am J Kidney Dis,1998,31:74-80.

收稿日期：2000-03-21