62例终末期肾病患者营养状态的评估与分析

Evaluation of nutrition status in patients with End-Stage Renal Disease

目的探讨改良主观综合性营养评估法(MSGA)对终末期肾病(ESRD)维持性血液透析患者营养状态的评估作用。方法应用MSGA对62例ESRD维持性血液透析患者进行营养评估,将MSGA的营养不良评分(MS)与各项客观营养指标进行相关性分析。结果MS平均值为(18.57±6.34)分,与年龄和超敏C反应蛋白(hs-CRP)呈正相关(P均<0.05),与体质量指数(BMI)、标准化蛋白分解代谢率(nPCR)、肱三头肌皮褶厚度(TSF)、上臂围(MAC)、上臂肌围(MAMC)、血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(Tf)、尿素氮(BUN)、总胆固醇(TC)呈负相关(P均<0.05)。偏相关分析显示,MS与nPCR、Alb、PA、Tf、TC呈负相关(P均<0.05),与hs-CRP呈正相关(P<0.05)。结论MSGA是一种能够更准确地反映ESRD维持性血液透析患者营养状态的定量营养评估方法。

Objective To explore the role of modified quantitative subjective global assessment of nutrition（MSGA） in evaluation of nutrition status in End-Stage Renal Disease（ESRD） patients with main- tenanee hemodialysis（MHD）. Methods The nutrition status of sixty-two ESRD patients with MHD were evaluated by using MSGA. At the same time,the anthropometric measurements including mid-arm circum-ference （MAC） , mid-arm muscle circumference （ MAMC ） , triceps skinfold （TSF） , body mass index （BMI） and some other objective parameters associated with malnutrition including normalized protein cat-abolic rate （ nPCR）, serum albumin （Alb）, prea/humin （PA）, hemoglobin （Hb）, Serum Transferrin （Tf） ,ereatinine （ Cr）, urea nitrogen （BUN）, total cholesterol （ TC ）, Highsensitivity C-reactive protein （hs-CRP） were measured in MHD patients. Pearson＇ s correlation analyse and partial correlation analyse were utilized to assess the relationship of malnutrition score（ MS, assessing the value of MSGA） and some other objective nutritional parameters. Results The mean value of MS was （18.57± 6.34）. MS was significantly related to age, BMI, MAC, TSF, MAMC, nPCR, Alb, PA, Tf, BUN, TC and hs-CRP by Pearson relativity analysis （ P 〈 0.05 ）. Controlling the variables of age, weight and height, MS showed a significantly correlation with nPCR, Alb, PA, Tf,TC and hs-CRP by partial correlation analysis （P 〈 0.05 ）. Conclusion MSGA is a more accurate quantitative evaluation method of malnutrition in ESRD patients with MHD.