摘要
目的:用营养不良-炎症评估(MIS)方法全面评估维持性血液透析(MHD)患者的营养状况,并找出导致营养不良的主要原因;分析患者营养不良发生的相关危险因素。方法:选取南京市浦口区中心医院101例维持性血液透析患者,根据MIS评分分为轻度营养不良组和中重度营养不良组,观察两组在生化指标及人体测量指标之间的差异。结果:轻度营养不良组与中重度营养不良组年龄、肌酐、铁蛋白、上臂围(MAC)、肱三头肌皮皱厚度(TSF)、上臂中部肌围(MAMC)、体重指数(BMI)、尿素清除率(KT/V)、改良主观综合性评估(MQSGA)等方面,差异均有统计学意义(P<0.05)。按照年龄分为老龄组和非老龄组,非老龄组尿素、肌酐、尿酸等方面均高于老龄组(P<0.05);老龄组MQSGA、MIS评分等方面均高于非老龄组,差异均有统计学意义(P<0.01)。根据C反应蛋白(CRP)水平分为CRP<1组和CRP≥1组,结果显示两组人体测量指标及评分方面比较,差异均无统计学意义(P>0.05)。MAC、TSF、MAMC、BMI、MQSGA与MIS评分有明显的相关性。结论:本院血液透析中心MHD患者整体营养状态较好。MHD患者血液透析充分,营养不良的主要原因是蛋白质摄入不足。年龄越大,越容易出现营养不良。
Objective:To evaluate the use of malnutrition inflammation(MIS)method for comprehensive assessment of maintenance hemodialysis(MHD)patients nutritional status,and find out the main causes of malnutrition,analysis of the related risk factors of malnutrition in patients.Method:Nanjing Pukou Central Hospital,101 cases of hemodialysis patients,according to MIS they were divided into mild malnutrition group and moderate to severe malnutrition group,the differences between two groups in biochemical and anthropometric parameters were observed.Result:Age,creatinine,ferritin,MAC,upper arm circumference,triceps skinfold(TSF),mid arm muscle circumference(MAMC),body mass index(BMI),urea clearance rate(KT/V),the modified subjective comprehensive evaluation(MQSGA)of mild malnutrition group and moderate to severe malnutrition group,the differences were statistically significant(P<0.05).According to the age they were divided into aging group and non elderly group age,non aged group were higher than those of aging group in urea,creatinine and uric acid(P<0.05),aged group was higher than that of non aged group in MQSGA and MIS scores,the differences were statistically significant(P<0.01).According to C reaction protein(CRP)levels,they were divided into CRP<1 group and and CRP≥1 group,the results showed that two groups in terms of anthropometric indexes had no significant differences(P>0.05).MAC,TSF,MAMC,BMI and MQSGA were significantly correlated with MIS scores.Conclusion:The nutritional status of MHD patients in our hemodialysis center is better.Hemodialysis is the cause of malnutrition in MHD patients.The main cause of malnutrition is insufficient protein intake in patients.The older you are,the more likely you are to become malnourished.
作者
张淑华
夏群
ZHANG Shuhua;XIA Qun(Nanjing Pukou Central Hospital,Nanjing 211800,China)
出处
《中国医学创新》
CAS
2017年第32期37-40,共4页
Medical Innovation of China
基金
2015年度南京市医学科技发展项目(YKK15215)
关键词
血液透析
营养状态
营养不良-炎症评估
Hemodialysis
Nutritional status
Malnutrition inflammation evaluation
