维持性血液透析患者营养不良情况及其影响因素分析

Analysis of Prevalence of Malnutrition and Associated Factors in Maintenance Hemodialysis Patients

目的:分析维持性血液透析(MHD)患者营养不良发生率以及营养不良的影响因素。方法:选择2015年~2016年在我院进行MHD治疗的142例患者作为研究对象,采用改良定量主观整体评估表(MQSGA)结合实验室生化指标、人体测量学指标综合评估透析患者营养状况,并分析MHD患者发生营养不良的危险因素。结果:MQSGA评估结果显示营养正常组有63例,占总人数44.37%,营养不良组有79例,占总人数55.63%,其中轻中度营养不良有68例,占总人数47.88%,重度营养不良有11例,占总人数7.74%。营养正常与营养不良组间CRP、Alb、BUN、TSF、BMI、kt/v、年龄、透析龄比较差异有统计学意义(P<0.05)。Logistics回归模型结果显示KT/V<1.2,年龄、透析龄、Alb是营养不良的独立危险因素。结论:MHD患者营养不良的发生率较高,影响因素多,其中KT/V<1.2,年龄、透析龄、Alb是其危险因素,可作为评估患者营养状况的指标。

Objective： To analyze the incidence of malnutrition and the influencing factors of malnutrition in maintenance hemodialysis（MHD） patients. Methods： 142 patients undergoing MHD treatment in our hospital from 2015 - 2016 were involved in this study. Assessment of malnutrition status and analysis the risk factors relied on Modified Quantitative Subjective Global Assessment（MQSGA） combining with laboratory biochemical indexes and Anthropometric Examinations. Results： According to MQSGA,there were sixty-three patients in normal nutrition group（44. 73%） and seventy-nine patients in malnurition group（55. 63%）,in which sixty-eight patients suffered from mild and moderate malnutrition（47. 88%） and eleven patents attacked by severe malnutrition（7. 74%）. The indexs of CRP、Alb、BUN、TSF、BMI、kt/v、age and hemodialysis duration were significantly diferent in diferent nutritional status groups（P〈0. 05）. Logistic regression analysis showed that the risk factors for malnutrition in MHD patients included Kt/V 1. 2,Alb,age and hemodialysis duration. Conclusion： MHD patients showed high prevalence of malnutrition,and associated with many factors,among which Kt/V 〈1. 2,Alb,age and hemodialysis duration were the the risk factors,which could be used to assess the malnutrition in MHD patients.