http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : 최의진 ( Eu (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
-
복막투석 환자에서 체액량 결정을 위한 Bioimpedance Analysis의 유용성
송호철 ( Ho Cheol Song ),주겨레 ( Kyu Re Joo ),홍유아 ( Yu Ah Hong ),이현정 ( Hyun Jeong Lee ),김용균 ( Yong Gyun Kim ),신석준 ( Seok Joon Shin ),김병수 ( Byung Soo Kim ),김영옥 ( Young Ok Kim ),김용수 ( Yong Soo Kim ),최의진 ( Eu 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2
목적: 복막투석을 시행하는 말기신부전 환자에서 정확한 체액량의 결정과 조절이 고혈압의 치료에 필수적이다. 그러나 현재의 경험적 방법에 의한 건체중의 결정은 특이성과 감수성이 낮아 객관적인 방법이 필요한 상태이다. 본 연구는 복막 투석환자의 체액량 결정에 bioimpedance analysis (BIA)의 유용성 알아보기 위하여 시행하였다. 방법: 안정적으로 복막투석 중인 환자 32명을 대상으로 하여 24시간 생활혈압 (24 hours ambulatory blood pressure), ANP (atrial natriuretic peptide), PET (peritoneal equilibration test)를 시행하였고, 혈압을 기준으로 정상혈압군 (A군, 11명), 고혈압이 있으나 약물치료를 통해 평균혈압이 130/80 mmHg 이하로 조절되는 군 (B군, 9명), 그리고 2가지 이상의 약물투여에도 불구하고 평균혈압이 130/80 mmHg 이상인 군 (C군, 12명)으로 나누었고, 이들 환자를 대상으로 BIA를 시행하여 nECF (normalized Extracellular fluid: ECF/Height), ECF/ICF (Extracelluar fluid/Intracellular fluid ratio), ECF/TBW (Extracellular fluid/Total body water) 지표를 측정하고 그 결과를 비교하였다. 또한 측정치를 정상신기능을 가진 종합검진 환자에서 측정한 BIA의 결과와 비교하였다. 결과: 대상 환자의 평균 연령은 53±12세였고, 남녀 비 1:1.5이었으며, 평균 49±38개월 동안 복막투석을 받고 있었다. 본 연구의 대상에서 A군 (10.3±7.2 pg/mL), B군 (13.7±8.1 pg/mL)군에 비해 C군 (53.1±13.6 pg/mL)에서 ANP의 측정치가 유의하게 높았고 (p<0.05), BIA를 이용하여 측정한 nECF, ECF/ICF, ECF/TBW 각각의 측정치가 C군에서 A, B군에 비해 유의하게 높았으나 A군과 B군과는 유의한 차이를 보이지 않았다. 또한 정상신기능을 가진 대상에서 측정한 nECF, ECF/ICF, ECF/TBW 측정치는 A, B군과는 차이를 보이지 않았으나 C군에 비해 유의하게 낮게 측정되었다 (p<0.05). ANP의 측정치와 nECF, ECF/ICF, ECF/TBW의 경우 의미있는 상관관계를 보였다 (p<0.05). PET의 결과에 따른 ANP와 BIA 측정치는 의미있는 차이는 보이지 않았다. 결론: 안정적으로 복막투석중인 환자에서 BIA의 측정은 환자의 체액량의 상태를 예측할 수 있는 유용한 지표의 하나로 판단되며 향후 임상에서 적용을 위해 전향적 연구가 필요하다. Purpose: Determination of accurate body fluid is essential for treating hypertension in end stage renal disease patients undergoing dialysis. However, the determination of dry body weight based on clinical assessment has low sensitivity and specificity. This study was done in order to examine the usefulness of bioimpedance analysis in determining the volume of CAPD patients. Methods: Twenty-four hours ambulatory blood pressure and plasma concentrations of atrial natriuretic peptide (ANP) were measured and peritoneal equilibration test (PET) were obtained from 32 stable CAPD patients. Patients were divided into three groups; patients with normal blood pressure (group A, 11 people), and patients who have hypertension but controlled (under 130/80mmHg) with anti-hypertension medication (group B, 9 people), patients who have high blood pressure (over 130/80 mmHg) with 2 more anti-hypertension medication (group C, 12 people). We measured normalized extracellular fluid (nECF), extracelluar fluid/intracellular fluid ratio (ECF/ICF) and extracellular fluid/total body water (ECF/TBW) of each group by using bioimpedance analysis (BIA) and compared the results of each group. We also compared the values of nECF, ECF/ICF, ECF/TBW indices from patients with those from normal renal function people. Result: Thirteen men and nineteen women participated in this test. Their mean age was 53±12 years and mean duration of CAPD was 49±38 months. Among three groups, plasma ANP level in group C (53.1±13.6 pg/mL) was significantly higher than the level in group A (10.3±7.2 pg/mL) and B (13.7±8.1 pg/mL) (p<0.05). The values of nECF, ECF/ICF, ECF/TBW that measured by BIA in group C was significant higher than the values in group A and B, but the values in group A and B were not significant different. The values of nECF, ECF/ICF, ECF/TBW from patients with normal kidney function were not different from those of group A and B, but the values were significantly lower than the values in group C (p<0.05). Plasma ANP level was correlated with nECF, ECF/ICF, ECF/TBW (p<0.05) value. Plasma ANP and nECF, ECF/ICF, ECF/TBW was not influenced different PET result. Conclusion: BIA is considered as a useful standard to predict the volume status in CAPD patients. In the future, prospective studies are demanded for clinical application.
-
이광우,이해규,김진우,손호영,차봉연,강무일,윤건호,유순집,강성구,김태규,윤형규,최의진,한훈 대한내과학회 1995 대한내과학회지 Vol.48 No.6
Autoimmune polyglandular syndrome encompasses a number of diseases, ranging from unusual endocrine and nonendocrine disorders to the co-occurrence of common organ specific autoimmune disease. Knowledge of these syndrome is important for several respects: given the presence of one disease, certain others become more likely(in relatives as well as in the primary patient); there are similarities in the etiology and genetics of the different diseases; and immunologic treatment of one disease may be applicable to others. We recently experienced type II autoimmune polyglandular syndrome in a twenty-two-year old female patient who had insulin dependent diabetes mellitus associated with diabetic ketoacidosis, Hashimoto's thyroiditis, autoimmune Addison's disease, primary gonadal failure and alopecia totalis. Among the family member, twenty-year-old sister showed primary gonadal failure. Evaluation of the histocompatibility leukocyte anti- gene(HLA) was done in the patient and 4 relatives by two-step polymerase chain reaction(PCR). In HLA typing, the patient showed HLA-Al, B8, DR3, DR4 haplotypes, which had been known to be related with the autoimmune polyglandular syndrome.
ScienceON
KISS연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
