维持血透患者代谢性酸中毒与营养状况的关系  

The Relationship between Metabolic Acidosis and Nutritional Status in Maintained Hemodialysis Patients

作　　者：汪鹏[1] 牛建英[1] 陶琳[1] 范伟峰[1] 李亚霖[1] 罗丽红[1] 顾勇[1] 

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240

出　　处：《中国临床医学》2007年第1期86-88,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨维持血透患者代谢性酸中毒与营养状况的关系。方法:选择44例血透患者,采血测pH、HCO_3^-、BUN、Scr、总蛋白、ALB、前白蛋白、血常规、电解质、iPTH等并计算eKT/V。同时行人体学测量、营养不良-炎症评分(MIS)。将患者按透前HCO_3^-分为高HCO_3^-组(HCO_3^-≥20mmol/L)和低HCO_3^-组(HCO_3^-＜20mmol/L)。结果:两组间RBC、BUN、血钙、血磷差异显著(P＜0．05)。透前HCO_3^-与RBC、Hct、血钙正相关(P＜0．05),与BUN负相关(P＜0．05);低HCO_3^-组内,透前HCO_3^-与总胆固醇、TG、干体重正相关,与MIS负相关(P＜0．05)。结论:代谢性酸中毒与维持血透患者患者贫血和钙磷代谢紊乱相关,与营养不良的关系在HCO_3^-＜20mmol/L患者中较明显。Objective：The aim of this study was to evaluate the relationship between metabolic acidosis and nutritional status in maintained hemodialysis patients. Methods：44 patients were enrolled in the study, their plasma bicarbonate concentration, pH value, blood urea nitrogen, serum creatinine, total protein, albumin, pre-albumin, electrolyte, iPTH were measured, and eKT/V were calculated. At the same time, anthropometric measurement and malnutrition-inflammation score（MIS） assessment were made. The recruited patients were assigned to two groups, high bicarbonate（≥20mmol/L） or low（〈20mmol/L） bicarbonate group, based on predialysis bicarbonate concentrations. Results： Compared with high bicarbonate group, low bicarbonate group had relatively higher RBC, BUN, serum phosphorus and eKT/V, lower serum total calcium （P〈0.05）. Predialysis bicarbonate concentrations correlated positively with RBC, Hct and serum total calcium（P〈0.05） ,and negatively with BUN（P 〈0. 05）. And there were positive correlations between predialysis bicarbonate concentrations with total cholesterol, triglyceride（TG）, dry body weight, negative correlations with MIS within low bicarbonate group （P〈0. 05）. Conclusion： Predialysis metabolic acidosis is very common in maintained hemodialysis patients, which may be associated with nutritional status in this special population, especially when their predialysis bicarbonate concentrations lower than 20 mmol/L. In addition, metabolic acidosis may be associated with anemia and disorder of calcium and phosphorus metabolism.

关 键 词：维持性血液透析 代谢性酸中毒 营养不良 

分 类 号：R459.5[医药卫生—治疗学]