老年腹膜透析患者维生素水平调查

Vitamin levels of elderly patients with continuous ambulatory peritoneal dialysis

目的了解老年持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者维生素水平及其临床意义,为合理的营养干预提供借鉴。方法选择2019年3月~2021年3月在长海医院腹膜透析中心行腹膜透析的共242例患者为研究对象,分为老年组(年龄≥60岁)和非老年组(年龄<60岁),检测所有患者各族维生素水平及部分临床化验和检查指标,比较2组患者的维生素水平、相关化验和检查指标,计算老年腹膜透析患者维生素水平与各指标间的相关性。结果老年组血肌酐水平(t=-6.989,P<0.001)、尿素氮水平(t=-2.044,P=0.042)和甲状旁腺激素水平(t=-2.048,P=0.042)低于非老年组,老年组维生素A水平(t=-2.629,P=0.009)、维生素B1水平(t=-2.115,P=0.035)、维生素B9水平(t=-2.250,P=0.025)低于非老年组。Pearson相关分析显示年龄与维生素A水平(r=-0.223,P=0.036)、维生素B6水平(r=-0.270,P=0.011)呈负相关,血红蛋白水平与维生素C水平(r=0.421,P<0.001)、维生素E水平(r=0.265,P=0.013)呈正相关,三酰甘油水平与维生素B9水平呈正相关(r=0.218,P=0.042),铁蛋白水平和维生素B水平呈正相关(r=0.217,P=0.043)。老年组维生素A(χ^(2)=5.826,P=0.016)、维生素B2(χ^(2)=20.823,P<0.001)、维生素B12(χ^(2)=8.150,P=0.004)的缺乏率高于非老年组。结论老年腹膜透析患者存在普遍的维生素缺乏现象,维生素水平与部分临床化验和检查指标存在相关性,有必要监测老年患者的维生素水平并及时补充。

Objective To investigate vitamin levels of elderly patients with continuous ambulatory peritoneal dialysis and clinical significance of vitamin status,and to provide proper reference for nutritional intervention.Methods Totally,242 patients undergoing continuous ambulatory peritoneal dialysis at Peritoneal Dialysis Center of Changhai Hospital from March 2019 to March 2021 were selected as subjects,with their age and sex recorded.The patients were divided into the elderly group and the non-elderly group.Vitamin levels and some other laboratory test results of these two groups were examined and compared.The correlation coefficient between vitamin levels and biochemical indicators of the elderly was also calculated.Results The serum creatinine levels(t=-6.989,P<0.001),urea nitrogen levels(t=-2.044,P=0.042)and parathyroid hormone levels(t=-2.048,P=0.042)in the elderly group were lower than those in the non-elderly group.The levels of vitamin A(t=-2.629,P=0.009),vitamin B1(t=-2.115,P=0.035)and vitamin B9(t=-2.250,P=0.025)in the elderly group were lower than those in the non-elderly group.Vitamin A(r=-0.223,P=0.036)and vitamin B6 levels(r=-0.270,P=0.011)were negatively correlated with age.Vitamin C(r=0.421,P<0.001)and vitamin E(r=0.265,P=0.013)levels were positively correlated with hemoglobin levels.Vitamin B9 levels were positively correlated with triglyceride levels(r=0.218,P=0.042).And vitamin B2 levels were positively correlated with ferritin levels(r=0.217,P=0.043).The deficiency rates of vitamin A(χ^(2)=5.826,P=0.016),vitamin B2(χ^(2)=20.823,P<0.001)and vitamin B12(χ^(2)=8.150,P=0.004)in the elderly group were significantly higher than those in the non-elderly group.Conclusion Vitamin deficiency is common in elderly patients with peritoneal dialysis and vitamin levels are associated with some clinical tests and examination indicators.It is necessary to monitor the vitamin levels of elderly patients and supplement them in time.