慢性肾脏病住院患者营养风险影响因素分析

Analysis of nutritional risk in inpatients with chronic kidney disease

目的了解慢性肾脏病(chronic kidney disease,CKD)住院患者的营养现状,分析影响营养风险的相关因素,为进一步的营养支持提供理论依据。方法采取便利抽样法,选取四川省成都市某三级甲等医院肾脏内科2018年1月—3月719例CKD住院患者为研究对象,应用营养风险筛查2002(Nutritional Risk Screening2002,NRS2002)进行营养风险筛查,使用χ2检验、t检验、单因素方差分析、多重线性回归分析探讨营养风险差异及影响因素。结果 719例CKD住院患者营养风险得分为(1.79±1.11)分,有营养风险的患者158例,占总人数的22.0%。不同年龄、性别、CKD分期及有无低蛋白血症、有无贫血的患者营养风险得分差异有统计学意义(P<0.05);多重线性回归分析显示血清白蛋白、性别、年龄是CKD住院患者营养风险得分的影响因素,营养风险得分与白蛋白呈负相关(P=0.016),与年龄呈正相关(P<0.001),女性营养风险得分高于男性(P=0.001)。结论 CKD患者存在较高的营养风险,主要影响因素有年龄、性别、血清白蛋白。临床工作者需综合以上因素,继续采取有针对性的干预措施,较早、较方便地评估CKD患者的营养状态,为进一步的营养支持及营养护理提供科学依据。

Objective To explore the nutritional status of inpatients with chronic kidney disease(CKD)and analyze the factors affecting nutritional risk,to provide theoretical basis for further nutritional support.Methods Convenience sampling method was adopted to select 719 inpatients with CKD as research subjects in a tertiary hospital in Chengdu,Sichuan Province from January to March 2018.Nutritional Risk Screening 2002 was used for nutritional risk screening,and chi-square test,t test,one-way analysis of variance,and multiple linear regression analysis were used to explore the influencing factors of nutritional risk.Results Among the 719 cases,whose average nutritional risk score was 1.79±1.11,158 cases had nutritional risk,accounting for 22.0%.There were statistically significant differences in nutritional risk score between patients of age<60 years and≥60 years,between males and females,between patients with CKD stage 1-3 and stage 4-5,between patients with serum albumin level<30 g/L and≥30 g/L,and between patients with and without anaemia(P<0.05).The results of multiple linear regression analysis showed that the nutritional risk score of CKD patients was negatively correlated to serum albumin level(P=0.016),positively correlated to age(P<0.001),and higher in females than that in males(P=0.001).Conclusions Inpatients with CKD have a higher nutritional risk,with age,gender and serum albumin as the main influencing factors.Based on the above factors,the medical staff should continue to take targeted intervention measures to assess the nutritional status of CKD inpatients early and conveniently,so as to provide scientific basis for further nutritional support and nutritional nursing.