老年营养风险指数与非透析慢性肾脏病患者的血管钙化相关性研究

Correlation between geriatric nutritional risk index and vascular calcification in non-dialysis chronic kidney disease patients

目的 老年营养风险指数（GNRI）与非透析慢性肾脏病患者血管钙化的关系.方法 选取2016年1月至2017年8月非透析慢性肾脏病患者140例,根据腹部侧位X线片评估腹主动脉钙化情况,并计算GNRI.根据GNRI情况,将患者分成四组：无营养风险组37例,低营养风险组34例,中营养风险组36例,高营养风险组33例.对导致血管钙化的危险因素进行统计学分析.结果 无营养风险组、低营养风险组、中营养风险组和高营养风险组腹主动脉钙化积分分别为（3.58±2.41）、（10.50±1.86）、（16.25±1.89）和（20.54±1.92）分,四组比较差异有统计学意义（P〈0.05）.相关性分析结果显示,腹主动脉钙化评分与年龄和高血压呈正相关（r=0.61和0.35,P=0.001和0.003）,与估测肾小球滤过率和GNRI呈负相关（r=-0.36和-0.86,P=0.002和0.000）.多因素Logistic回归分析结果显示,年龄和GNRI是CKD患者发生腹主动脉钙化的独立危险因素（P〈0.01）.结论 GNRI与非透析慢性肾脏病患者的血管钙化呈负相关,加强其营养管理,可能预防心脑血管事件的发生.

Objective To explore the correlation between geriatric nutritional risk index （GNRI） and vascular calcification in non- dialysis chronic kidney disease （CKD） patients. Methods One hundred and forty non- dialysis CKD patients from January 2016 to August 2017 were selected. Abdominal aortic calcification score was evaluated by lateral abdominal radiography, and the GNRI was calculated. The patients were divided into 4 groups according to the GNRI： non-nutritional risk group （37 cases）, low nutritional risk group （34 cases）, middle nutritional risk group （36 cases） and high nutritional risk group （33 cases）. The risk factors leading to vascular calcification were analyzed statistically. Results The abdominal aortic calcification score in non- nutritional risk group, low nutritional risk group, middle nutritional risk group and high nutritional risk group was （3.58 ± 2.41）, （10.50 ± 1.86）, （16.25 ± 1.89） and （20.54 ± 1.92） scores, and there was statistical difference （P〈0.05）. Correlation analysis result showed that abdominal aortic calcification score was positively correlated with age and hypertension （r = 0.61 and 0.35, P = 0.001 and 0.003）, and negatively correlated with estimated glomerular filtration rate and GNRI （r = - 0.36 and - 0.86, P = 0.002 and 0.000）. Multivariate Logistic regression analysis result showed that age and GNRI were independent risk factors for abdominal aortic calcification in CKD patients （P〈0.01）. Conclusions GNRI is negatively correlated with vascular calcification in non- dialysis CKD patients. Strengthening nutritional management may prevent cardiovascular and cerebrovascular events.