尿毒症患者营养评估及相关因素分析

THE NUTRITIONAL STATUS AND RELATED FACTORS IN URAEMIC PATIENTS

目的 : 了解终末期肾病 (ESRD)患者透析前和维持性血液透析时的营养状态及其相关因素。方法 : 用主观综合营养评估法 (SGA)评估 46例透析前 ESRD患者和 78例维持性血透患者的营养状况及血浆白蛋白 (ALB)等其它营养指标 ,分析了影响透析前后营养状况的有关因素。结果 : 根据 SGA分级透析前组总营养不良的发生率为 65 .2 3 % ,维持性血透组为 5 8.97% ;残肾功能与透析前营养不良的相关性不明显 ,透析组 SGA分级三组之间 ALB、Pre-ALB、Chol、SCr、n PCR、年龄、糖尿病肾病比例、心血管疾病、肝硬化、感染等合并症和并发症发生率有显著性差异 ,而透析时间、KT/ V各组间无显著性差异。结论 : ESRD患者在透析前和维持性透析时有较高的营养不良的发生率 ,老龄、糖尿病、伴心血管疾病。

Objective: To investigate the nutritional status and related factors in end stage of renal disease (ESRD) patients before dialysis and at chronic haemodialysis state. Methods: The nutritional status of 46 uraemic patients before dialysis and 78 patients receiving chronic haemodialysis were evaluated by subjective global assessment (SGA) grading.The other nutritional parameters such as albumin (ALB), pre albumin (Pre ALB), cholesterol (Chol), serum creatinine (Scr), normalized protein catabolic rate (nPCR ) were also determined. Both the relationship between the renal function and nutritional status before dialysis and at chronic haemodialysis state were analyzed. Results: The prevalence of malnutrition of new dialysis patients and chronic haemodialysis patients was 65.23%,58.97% respectively according to SGA grading. There were no significantly statistical differences of renal function in SGA grading groups. There were significantly statistical differences of ALB, Pre ALB, Chol, Scr, nPCR, ages, percent of diabetes, co morbid diseases such as infections, cardiovascular disease, cirrhosis between different SGA grading groups. However there were no significantly statistical differences of dialysis time and urea clearance index (KT/V) between different SGA grading groups. Conclusion: Malnutrition is prevalent in patients with ESRD before dialysis and at chronic haemodialysis state. Ages, diabetes, co morbid diseases such as infections, cardiovascular disease, are strong predictors of increased malnutrition.