慢性肾衰竭维持性血液透析患者发生蛋白质能量消耗的影响因素

Influencing Factors of Protein Energy Wasting in Patients with Chronic Renal Failure Undergoing Maintenance Hemodialysis

目的研究慢性肾衰竭维持性血液透析患者发生蛋白质能量消耗(PEW)的影响因素。方法选取2016年7月至2020年7月我院收治的70例维持性血液透析患者,按照透析方式随机分为低通量组(n=30)和高通量组(n=40),比较两组PEW发生率;按照高通量组经治疗后有无发生PEW将该组内患者分为PEW组及非PEW组,比较两组性别、年龄、原发病、代谢性酸中毒、KT/V、CRP、IL-6水平,将有差异信息纳入Logistic回归分析模型,明确PEW发生的危险因素。结果高通量组经血液透析治疗后PEW发生率为32.50%显著低于低通量组56.67%(P<0.05)。PEW组年龄≥65岁、KT/V<1.2患者比例及CRP、IL-6水平显著高于非PEW组(P<0.05)。年龄、KT/V、CRP、IL-6是高通量血液透析患者发生PEW的危险因素。结论高龄及CRP、IL-6水平升高均可能引起高通量血液透析患者发生PEW。

Objective:To study the influencing factors of protein energy wasting(PEW)in patients with chronic renal failure undergoing maintenance hemodialysis.Methods:70 maintenance hemodialysis patients admitted to our hospital from July 2016 to July 2020 were randomly divided into low-flux group(n=30)and high-flux group(n=40)according to dialysis methods,and the incidence of PEW was compared between the two groups.Patients in the high-flux group were divided into PEW group and non-PEW group according to whether PEW occurred after treatment.The levels of gender,age,primary disease,metabolic acidosis,KT/V,CRP and IL-6 in the two groups were compared,and the difference information was incorporated into Logistic regression analysis model to identify the risk factors of PEW.Results:The incidence of PEW in high-flux group after hemodialysis was 32.50%,which was significantly lower than that in low-flux group(56.67%,P<0.05).The proportion of patients with age≥65 years old and KT/V<1.2and the levels of CRP and IL-6 in PEW group were significantly higher than those in non-PEW group(P<0.05).Age,KT/V,CRP and IL-6 are the risk factors of PEW in patients with high-flux hemodialysis.Conclusion:As the increase of CRP and IL-6 levels in elderly patients,PEW may occur in high-flux hemodialysis patients.