腹膜透析患者主观综合性营养评估(SGA)的临床研究

Clinical study on subjective global assessment of nutritional status in peritoneal dialysis patients

目的：观察主观综合性营养评估（ Ｓ Ｇ Ａ） 对持续不卧床腹膜透析（ Ｃ Ａ Ｐ Ｄ） 患者营养状态的评估价值。方法：对２３ 例 Ｃ Ａ Ｐ Ｄ患者进行 Ｓ Ｇ Ａ，并对其中１７ 例接受饮食强化治疗的患者进行了６ 个月前瞻性观察。结果：２３ 例患者中营养良好１２ 例（５２ ．２ ％ ） ，轻至中度营养不良９ 例（３９ ．１ ％ ） ，严重营养不良２ 例（８ ．７ ％ ） 。 Ｔ Ｐ、 Ａｌｂ 、 Ｈｂ 、 Ｂ Ｕ Ｎ、 Ｔ Ｇ、 Ｃｈ 及 Ｋ Ｔ／ Ｖ、ｎ Ｐ Ｃ Ｒ、ｒ Ｃｃｒ 以及蛋白质和热量摄入等客观检查指标在 Ｓ Ｇ Ａ 评估为营养良好与营养不良两组之间差异显著，有统计学意义；１７ 例饮食强化治疗后体重、上臂肌围及 Ｔ Ｐ、 Ａｌｂ 、 Ｔ Ｇ、 Ｂ Ｕ Ｎ、 Ｈｂ 等显著增加（ 均有统计学意义） ， Ｓ Ｇ Ａ 评估结果与各项客观指标之间的相关系数均在０ ．９０以上，具有显著的统计学意义。结论： Ｓ Ｇ Ａ 营养评估法能准确反映腹膜透析患者的营养状态，是一种较为理想的评估方法。

Purpose:To study the value of evaluating nutritional status in continuous ambulatory peritoneal dialysis(CAPD) patients by subjective global assessment(SGA). Methods:SGA was used in 23 patients on CAPD,and 17 out of them accepted intensive dietary treatment and were followed up to 6 months.Results:Among these 23 cases,12(52.2%) were judged as well nourished,9(39.1%) as mildly or moderate malnourished and 2(8.7%) as seversly malnourished.There were significant differences between the well nourished and the malnourished groups including KT/V,nPCR,Ccr,TP,Alb,Hb,Ch,TG and BUN etc .Compared with before intensive dietary treatment,the SGA parameters of nutrition increased significantly in 17 cases.Moreover,SGA was well correlated with parameters of nutrition( r ≥0.90, P <0.01). Conclusion:SGA could well reflect the nutritional status of CAPD patients.It is a simple,comprehensive and unaffected method of nutritional assessment.