肝硬化患者身体组成成分变化特点分析

Metabolic characteristic of body composition in patients with liver cirrhosis

目的:分析不同状态肝硬化患者身体组成成分的变化、建立肝硬化患者的组织丢失模式。方法:采用X线双能吸收测量法检测60例肝硬化患者及17例对照组人员的细胞外液(ECW)、细胞内液(ICW)、总体水(TBW)、体细胞数量(BCM),采用脂肪测定仪测定患者总脂肪(TBF)含量,通过百分位分布表计算身体组织的BCM和TBF的百分比,并与健康对照人群比较,建立组织丢失模式。结果:与健康对照组相比,肝硬化组的体质指数差异无显著性意义(P>0.05),但肝硬化组的BCM、TBF均明显减少(P<0.002;P<0.001),ECW明显增加而ICW明显减少(P<0.001;P<0.002);其中BCM、TBF、ICW随患者的Ch ild-Turcotte-Pugh(CTP)评分的提高下降也越明显,CTP A级患者以体内脂肪损失为主,CTP C级患者体细胞和脂肪同时耗尽。结论:重视防治肝硬化患者早期的脂肪损失及晚期的体细胞的快速丢失对纠正患者的营养不良、改善预后及提高生存质量将起到积极的作用。

Objective： To quantify the metabolic characteristic of body composition in patients with liver cirrhosis, then to establish the pattern of tissue loss for cirrhosis patients. Methods： Total body water （TBW）, extracellular and intracellular water （ECW and ICW）, body cell mass （BCM） and total body fat （TBF） were measured using absorptiometry techniques in 60 patients with liver cirrhosis; seventeen health people as control group. The percentage of BCM and TBF were calculated through percentile distribution tables. Results： Comparing with control group, ECW increasing and ICW decreasing were significant respectively in the patient＇s group （P 〈0. 001 ; P 〈0. 002） except body mass index （P 〉0. 05） . TBF loss mainly in Child-Turcotte-Pugh （CTP） class A patients, but BCM and TBF being depleted significantly in CTP class C patients. Conclusions： It is important to prevent and treat TBF loss in the early stage and BCM depletion in the terminal stage for the cirrhosis patient＇s malnutrition rectification and survival quality improvement.