综合性营养评估法在维持性血液透析患者中的应用分析

Application of General Nutrition Evaluation of the Nutritional Status in Maintenance Hemodialysis Patients

目的 对血液透析患者的几项营养指标进行评估。方法 依据SGA评分对142例维持性血液透析患者进行主观综合性营养评估（SGA）、膳食调查、生化参数的测量。结果 平均每日每公斤体重能量和蛋白质摄入（DEI、DPI）、血白蛋白，均有显著性差异（P〈0．001—0．05）。但营养良好组的DPI和DEI异常率高达49．0％、46．0％，重度营养不良组中各指标异常率均在80％以上。血前白蛋白与白蛋白有显著相关（P〈0．01），与DPI、DEI均无相关。结论 SGA是评价血透患者营养状况的简便方法，但还需其它反映营养状况不同侧面的指标的补充，如DEI、DPI、血白蛋白。前白蛋白作为血透患者营养监测的常规指标有待进一步证实。

Objective To evaluate the nutritional stutus of maintenance hemodialysis patients. Methods Dietery survey was made to 142 maintenance hemodialysis patients and biochemical index were measured according to SGA. Results There existed a great difference in the energy intake,the intake protein and serum albumin per kg per day （P 〈0. 001 -0. 05）. The abnormal rates of DPI and DEI in normal nutrion group were 49. 0% and 46.0% , while those in severe malnutrion group were over 80% Serum pre-albumin was closely correlated with Alb （ P 〈 0. 001 ） but not with DPI and DEI. Conclusions SGA is simple in measuring nutritional status of maintenance hemodialysis, but other index refecting different aspects of nutritional status will be needed, such as DPI, DET and Alb. PA is not recommended as routine measures of nutritional stutus in maintenance hemodialysis patients.