摘要
目的:评价人体成分测量在血液透析患者营养状态评估中的运用价值。方法:选择2017年02月~2018年10月间我院血液净化中心透析龄大于3个月的维持性血液透析(maintenance hemodialysis,MHD)患者196例,采用多频生物电阻抗法(bioelectric impedance analysis,BIA)进行人体成分测量,内容包括:体质量指数(BMI),体脂比,瘦体重(体重-脂肪重量),水过多(Over Hydration,OH),干瘦体重(瘦体重-OH),细胞外液与总体水之比(ECW/TBW),结合血清营养指标评价患者营养状态。结果:两两比较显示:对MHD患者营养不良判断的评价,人体成分测量中的干瘦体重指标明显优于瘦体重指标及血清中白蛋白(Alb),前白蛋白(PAB),转铁蛋白(Tf)、胆固醇(TC)对患者营养不良的判断(P<0.01);瘦体重指标对患者营养不良的判断优于血清中白蛋白,前白蛋白,转铁蛋白、胆固醇对营养不良的判断(P<0.01)。Spearman相关分析结果显示:人体成分测量中的干瘦体重与BMI、体脂百分比呈正相关(r=0.294及r=0.183,P均<0.05),与患者年龄、ECW/TBW及OH值呈负相关(r=-0.215,r=-0.198及r=-0.447,P均<0.05);Logistic回归分析显示:干瘦体重、年龄、OH值为MHD患者营养不良的独立危险因素。结论:生物电阻抗技术较血清学对MHD患者营养不良的评估具有无创、经济、灵活等优点,可用于MHD患者早期营养不良的判断及指导临床对患者营养不良进行干预。
Objective:To discuss clinical value of nutritional status in maintenance hemodialysis(MHD) patients by body composition measurement.Methods:196 MHD patients of clinically stable in our hemopurification center from Feb 2017 to Oct 2018 were enrolled in this study. Dialysis age of all patients was more than 3 months, Nutrition status was evaluated by BIA method, including body mass index(BMI), body fat percentage, lean weight(body weight-body fat weight), Over Hydration(OH), dry lean weight(lean weight-OH) and ECW/TBW,the nutritional status of MHD patients was evaluated by combining serum nutritional indexes.Results:Comparison shows that the percentage of malnutrition by dry lean weight was obviously higher, compared with lean weight, serum albumin, pre-albumin, transferring and cholesterol(P<0.01), the percentage of malnutrition by lean weight was higher, compared with serum albumin, pre-albumin, transferring and cholesterol(P<0.01). Spearman correlation analysis showed that dry lean weight was positively correlated with BMI and body fat percenta ge(r=0.294,r=0.183,P<0.05),and negatively correlated with age, ECW/TBW and OH(r=-0.215,r=-0.198,r=-0.447,P<0.05). Logistic analysis revealed that dry lean weight, age and OH value was independently correlated with malnutrition.Conclusion:To compare lab tests, BIA has advantages of noninvasive,economic,flexible,and can be used for early malnutrition evaluation and intervention in MHD patients.
作者
陆晓凤
金炜
钱玲玲
张艳霞
沈娟娟
赵湘
LU Xiaofeng;JIN Wei;QIAN Lingling(Nephrology of Department,Tongxiang First People's Hospital,Zhejiang,Tongxiang,314500)
出处
《中国中西医结合肾病杂志》
2019年第10期876-879,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
浙江省自然科学基金资助项目(No.LY16H05004)
浙江省科技厅公益项目(No.2015C33204)
桐乡市引导性科技计划项目(No.201702095)
关键词
血液透析
生物电阻抗
营养
Hemodialysis
Bioelectric impedance
Nutrition
