血液透析患者营养状况调查及其影响因素

Investigation of nutritional status and its influencing factors in hemodialysis patients

目的 调查血液透析(HD)患者的营养状况及影响因素。方法 采用主观综合营养评估法(SGA)结合有关生化指标、人体测量指标及饮食评估对57例血液透析患者的营养状况进行综合评价。观察了营养状况与饮食摄入、透析充分性、透析时间、年龄的关系。结果 57例透析患者中营养良好35例(61.4％),轻至中度营养不良18例(31.6％),重度营养不良4例(7.0％),总营养不良的发生率为38.6％。各营养状况组之间血清白蛋白(Alb)、前白蛋白(PA)、肌酐(Scr)、三头肌皮皱厚度(TSF)、饮食蛋白摄入量(DPI)和蛋白分解率(nPCR)差异显著,而三组间Kt/V无显著差异。65岁以上老年患者营养不良发生率(50％)明显高于65岁以下患者(32.4％)。结论 血液透析患者营养不良的发生率较高,与蛋白质摄入不足、血液透析过程本身、年龄及炎症等因素有关。

Objective To investigate the nutritional status and its influencing factors in hemodialysis (HD) patients. Methods Subjective global assessment (SGA) were used to assess the nutritional status in 57 HD patients. At the same time, the biochemical parameters, anthropometric datas and dietary assessments were also measured. The correlation between nutritional status and dietary intake, dialysis adequacy, dialysis duration and age were observed. Results There were 35 patients (61.4% ) graded as of normal nutrition, 18 patients (31.6% ) of mild malnutrition and 4 patients (7.0%) of severe malnutrition. Serum albumin (Alb), prealbumin (PA), creatinine (Scr), triceps skinfold thickness (TSF), dietary protein intake (DPI), and normalized protein catabolic rate (nPCR) were significantly different between the three groups, whereas Kt/V was not. The prevalence of malnutrition in HD patients aged 65 years or older was significantly higher than that in patients aged below 65 years old (50% vs. 32.4%). Conclusions There is a high morbidity of malnutrition in HD patients. Influencing factors include low protein intake, dialysis factors, age and inflammation.