维持性血液透析患者的营养现状、人体成分分析及其影响因素

Nutritional status,human component analysis and its influencing factors in patients with MHD

目的探讨维持性血液透析(MHD)患者的营养现状、人体成分分析及其影响因素分析。方法选取2015年8月至2016年12月在该院治疗的MHD患者70例,采用改良定量主观整体评估表(MQSGA)评估患者营养状况,全自动生化分析仪测量患者前白蛋白(PA)、白蛋白(Alb)、血红蛋白(Hb)等,采用t检验、χ2检验比较营养不良和营养正常患者临床资料差异,多因素分析采用Logistic回归分析。结果经MQSGA量表评估,MHD患者营养不良率为64.3%;营养不良患者年龄为(65.6±5.5)岁,明显高于营养正常患者(P<0.05);营养不良患者体质量指数(BMI)、PA、Alb、Hb、蛋白质含量、骨骼肌量和体脂百分比分别为(20.1±2.0)kg/m^2、(270.0±45.6)mg/L、(31.2±3.3)g/L、(86.7±12.2)g/L、(8.3±1.4)kg、(27.8±2.4)kg和(25.7±2.0)%,明显低于营养正常患者(P<0.05);营养不良患者透析时间、有糖尿病比例、家庭月收入<5 000元比例分别为(34.5±12.0)月、53.3%和62.2%,明显高于营养正常患者(P<0.05);Logistic回归分析结果显示:年龄和透析时间是MHD患者发生营养不良的危险因素(OR=1.960、2.275,P<0.05),而家庭月收入是保护因素(OR=0.725,P<0.05)。结论MHD患者营养不良发生率较高,受患者年龄、透析时间及家庭收入影响。

Objective To investigate the nutritional status,human body composition distribution and its influencing factors of maintenance hemodialysis(MHD)patients.Methods 70 MHD patients treated in our hospital from August 2015 to December 2016 were selected,the nutritional status of patients was assessed by modified quantitative subjective global assessment scale(MQSGA),the prealbumin(PA),albumin(Alb)and hemoglobin(Hb)and so on were measured by Fully automatic biochemical analyzer,the difference of clinical data between malnutrition and normal nutrition patients were compared by t test andχ2 test,Logistic regression analysis was used for multivariate analysis.Results The malnutrition rate of MHD patients was 64.3%evaluated by MQSGA scale;The age of malnutrition patients was(65.6±5.5)years old,which was significantly higher than that of normal nutrition patients(P<0.05);The body mass index(BMI),PA,Alb,Hb,Protein content and skeletal muscle mass and body fat percentage of malnutrition patients were(20.1±2.0)kg/m^2,(270.0±45.6)mg/L,(31.2±3.3)g/L,(86.7±12.2)g/L,(8.3±1.4)kg,(27.8±2.4)kg and(25.7±2.0)%,which were significantly lower than those of normal nutrition patients(P<0.05);The dialysis time,the proportion of diabetes mellitus and the proportion of family monthly income<5 000 yuan in malnutrition patients were(34.5±12.0)months,53.3%and 62.2%,which were significantly higher than those in normal nutrition patients(P<0.05);Logistic regression analysis showed that age and dialysis time were risk factors for malnutrition in MHD patients(OR=1.960 and 2.275,P<0.05),while family monthly income was protective factor(OR=0.725,P<0.05).Conclusion The incidence of malnutrition in MHD patients is higher,which is influenced by age,dialysis time and family income.