标题：V1导联P波终末电势在血液透析患者容量超负荷评估中的价值

      作者：赵劲，李岩，刘芸辉    (中国人民武装警察边防部队总医院血透中心，广东 深圳 518029）

      卷次： 2017年28卷14期

      【摘要】 目的 观察维持性血液透析(MHD)患者干体质量达标前、后V1导联P波终末电势(PtfV1)的变化，探讨其在MHD患者容量超负荷评估中的临床价值。方法 从2015年3月至2016年6月在中国人民武装警察边防部队总医院行维持性血液透析的患者中，选择25例干体质量未达标(A组)和25例干体质量达标(B组)的患者，将A组通过 4周增加透析超滤量或透析频次使体质量逐渐下调到干体质量水平(C组)，并选择 25名同期在我院进行健康体检的健康成人作为对照组(D组)。测算各组心电图 PtfV1、检测血浆脑钠肽(BNP)并检查心胸比(CRT)等指标。结果 A组患者的PtfV1明显低于B组、C组和D组，BNP明显高于B组、C组和D组，CRT明显高于B组、C组和D组，差异均有统计学意义(P<0.05)；而B组、C组和D组患者的PtfV1、BNP和CRT比较差异均无统计学意义(P>0.05)；A组、C组患者的PtfV1变化与BNP、CRT均呈负相关(r=-0.753、-0.638，P<0.05)。结论 PtfV1对MHD患者容量超负荷的评估有一定临床价值。
      【关键词】 V1导联P波终末电势；维持性血液透析；脑钠肽；干体质量
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350(2017）14—2359—02

Value of P-wave terminal force in lead V1 for the assessment of fluid overload in hemodialysis patients.
ZHAO Jin,LI Yan, LIU Yun-hui. Hemodialysis Center, Corps Hospital of Chinese People's Armed Police Border Security Forces,Shenzhen 518029, Guangdong, CHINA
【Abstract】 Objective To observe the change of P-wave terminal force in lead V1 (PtfV1) in maintenance hemo-dialysis (MHD) patients before and after adjustment of dry weight to standard, and to explore its clinical value in evaluat-ing the fluid overload in MHD patients. Methods A total of 50 MHD patients treated in our hospital from March 2015to June 2016 were divided into four group: group A (dry weight not reach standard, 25 cases), group B (dry weight up tostandard, 25 cases), group C (people in group A whose dry weight was gradually reduced to standard by increasing dialy-sis ultrafiltration volume or dialysis frequency for 4 weeks), group D (25 healthy people who were underwent health ex-amination in our hospital at the same time). Measurements of each group were admitted on ECG PtfV1, plasma brain na-triuretic peptide (BNP) and cardiothoracic ratio (CRT). Results The PtfV1 of group A was significantly lower than thatof group B, C and D (P<0.05), while BNP and CRT of group A were significantly higher than those of group B, C and D(P<0.05). There was no significant difference in PtfV1, BNP and CRT among group B, C and D (P>0.05). The changes ofPtfV1 in group A and C were negatively correlated with BNP and CRT (r=-0.753, -0.638, P<0.05).Conclusion PtfV1has a certain clinical value in the assessment of fluid overload in MHD patients.
      【Key words】 P-wave terminal force in lead V1; Maintenance hemodialysis; Brain natriuretic peptide (BNP); Dryweight·临床经验·doi:10.3969/j.issn.1003-6350.2017.14.039