3种营养评估工具在腹膜透析患者中的应用比较
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Comparison of 3 nutritional assessment tools for peritoneal dialysis
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    摘要:

    目的 比较不同营养评估工具在腹膜透析患者中的应用价值。方法 采用便利抽样法,选取2022年10月至2023年10月在海军军医大学第二附属医院住院接受腹膜透析治疗的147例患者作为研究对象,应用7分主观整体评估法(7-SGA)、营养不良炎症评分法(MIS)、控制营养状况(CONUT)这3种评估工具对患者进行营养评估。采集患者的人体测量指标及血生化指标,并与营养评估工具评分进行相关性分析。结果 7-SGA、MIS、CONUT这3种营养评估工具评估营养不良的发生率分别为53.74%(79/147)、48.30%(71/147)、76.19%(112/147),用7-SGA和MIS评估的年龄>60岁腹膜透析患者的营养不良发生率均高于≤60岁患者(均P<0.01)。以7-SGA评估结果分组,营养不良腹膜透析患者的BMI、骨骼肌质量、骨骼肌质量指数、相位角、手握力、上臂围度、上臂肌围、皮褶厚度及白蛋白、前白蛋白水平均低于营养良好组(均P<0.05)。7-SGA评分与年龄呈负相关(P<0.05),与BMI、骨骼肌质量、骨骼肌质量指数、相位角、手握力、上臂围度、上臂肌围、皮褶厚度、白蛋白、前白蛋白、总蛋白、血肌酐、血红蛋白呈正相关(均P<0.05)。结论 腹膜透析患者营养不良发生率因所用的评估工具而异,7-SGA评分与人体测量指标和血生化指标的相关度高,有较高的有效性、可靠性和实用性,可以作为腹膜透析患者营养评估的优选工具。

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    Objective To compare the application value of different nutritional assessment tools for peritoneal dialysis patients. Methods A total of 147 patients who were hospitalized for peritoneal dialysis in The Second Affiliated Hospital of Naval Medical University between Oct. 2022 and Oct. 2023 were enrolled by convenience sampling method. The nutritional assessment was carried out by using 3 assessment tools, including 7-point subjective global assessment (7-SGA), malnutrition inflammation score (MIS) and controlling nutritional status (CONUT). Correlation analyses were conducted between the nutritional assessment results and anthropometric measurements and blood biochemical indexes. Results The incidence of malnutrition assessed by 7-SGA, MIS, and CONUT were 53.74% (79/147), 48.30% (71/147), and 76.19% (112/147), respectively. Both 7-SGA and MIS assessment revealed that the incidence of malnutrition in peritoneal dialysis patients > 60 years old was significantly higher than that in patients ≤60 years old (both P<0.01). Grouped by 7-SGA results, the body mass index (BMI), skeletal muscle mass, skeletal muscle mass index, phase angle, grip strength, upper arm circumference, upper arm muscle circumference, skinfold thickness, albumin and prealbumin levels in malnourished peritoneal dialysis patients were significantly lower than those in well-nourished peritoneal dialysis patients (all P<0.05). The 7-SGA score was negatively correlated with age (P<0.05), and was positively correlated with BMI, skeletal muscle mass, skeletal muscle mass index, phase angle, grip strength, upper arm circumference, upper arm muscle circumference, skinfold thickness, albumin, prealbumin, total protein, creatinine, and hemoglobin (all P<0.05). Conclusion The incidence of malnutrition in peritoneal dialysis patients varies with the assessment tools used. 7-SGA score has high correlation with anthropometric and blood biochemical indexes, and is effective, reliable, and practical. It is a good tool for nutritional assessment in patients undergoing peritoneal dialysis.

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  • 收稿日期:2024-09-11
  • 最后修改日期:2025-05-23
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  • 在线发布日期: 2025-07-22
  • 出版日期: 2025-07-20
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