| 摘要: |
| 目的 了解维持性血液透析患者(MHD)的营养状况,探讨其存在的逆流行病学现象,为进一步提出针对性营养干预策略提供依据.方法 采用主观综合性营养评估法(SGA)、人体测量、生化指标测定方法综合评估113例维持性血液透析患者的营养状态.结果 根据SGA评分,55.75%(63例)的患者营养状况良好;营养不良患者占44.25%(50例),其中39.82%(45例)为轻-中度营养不良,4.42%(5例)为重度营养不良.营养不良组患者肱三头肌皮褶厚度(TSF)、动静脉瘘对侧上臂周径(MAC)、上臂肌围(MAMC)低于营养良好组,差异有统计学意义(P<0.01).营养不良组总胆固醇(CH)、三酰甘油(TG)、低密度脂蛋白(LDL)、血清白蛋白(Alb)、前白蛋白(PA)、血肌酐(Scr)、尿素氮(BUN)、钙(Ca)、磷(P)较营养良好组低,其中TG、PA、Scr、BUN差异有统计学意义(P<0.05,P<0.01),而高密度脂蛋白(HDL)和甲状旁腺素(PTH)较营养良好组偏高,但差异无统计学意义.结论 MHD患者营养不良发生比例偏高,且MHD患者营养不良是导致其逆流行病学现象的原因之一,建议根据MHD患者具体的病理生理特点来调整治疗标准. |
| 关键词: 维持性血液透析 营养不良 逆流行病学现象 |
| DOI：10.3724/SP.J.1008.2015.00014 |
| 投稿时间：2014-03-17修订日期：2014-11-07 |
| 基金项目:第二军医大学长海医院"1255"学科建设计划(CH125532100). |
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| Nutritional status and inverse epidemiological phenomena of maintenance hemodialysis patients |
| SHEN Xiao-jie,WU Hao,YU Ri-zhen,KONG De-liang,GUO Zhi-yong,XU Jing* |
(Department of Nephrology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To understand the nutritional status of maintenance haemodialysis (MHD) patients and to discuss their reverse epidemiological phenomena, so as to provide evidence for further nutrition intervention strategies. Methods We evaluated the nutritional statuses of 113 MHD patients by combining the subjective global assessment (SGA) score, anthropometrics and biochemical tests. Results According to SGA scores, 63 patients (55.75%) were classified as well nourished, and malnutrition was observed in 50 patients (44.25%), with mild to moderate malnutrition in 45 patients (39.82%) and severe malnutrition in 5 patients (4.42%). The levels of triceps skin fold (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC) in malnutrition patients were significantly lower than those in the well-nourished group (P<0.01). The levels of total cholesterol (CH), triacylglycrol (TG), low density lipoprotein(LDL), serum albumin (Alb), prealbumin (PA), serum creatinine (Scr), blood urea nitrogen (BUN), calcium(Ca), and phosphorus (P) in malnutrition patients were lower than those in the well-nourished group(the differences for TG, PA, Scr, and BUN being statistically significant, P<0.05,P<0.01); the levels of high density lipoprotein (HDL) and parathyroid hormone (PTH) were higher than those in the well-nourished group, but showing no statistical significance. Conclusion Malnutrition is common in the maintenance hemodialysis patients, which is one of the reasons for the reverse epidemiological phenomena, so it is suggested that the treatment should be adjusted according to the specific pathophysiological characteristics of MHD patients. |
| Key words: maintenance hemodialysis malnutrition reverse epidemiological phenomena |
