维持性血液透析患者代谢性酸中毒与营养不良的关系  

Correlation between metabolic acidosis and malnutrition in patients undergoing maintenance hemodialysis

作　　者：孙淑清[1] 洪佳平[1] 余毅[1] 陈今[1] 林曰勇[1] 

机构地区：[1]南京军区福州总医院血液净化科,350025

出　　处：《实用医学杂志》2008年第7期1144-1146,共3页The Journal of Practical Medicine

摘　　要：目的:观察维持性血液透析(MHD)患者代谢性酸中毒(MA)的发生情况及其与机体营养指标的关系。方法:根据透析前血浆碳酸氢根(HCO3)浓度,将68例MHD患者分为两组:MA组(HCO3≤21mmol/L,40--例)和非MA组(HCO3>21mmol/L,28例),将两组患者的营养指标进行比较并分析HCO3浓度与各营养指标的--关系。结果:68例MHD患者MA发生率58.8%,透析前血清肌酐(SCr)、尿素氮(BUN)、标准化蛋白代谢率(nPCR)MA组明显高于非MA组(P<0.05),而白蛋白(Alb)、前白蛋白(PA)及体重指数(BMI)、肱三头肌皮褶厚度(TSF)两组间比较差异无显著性;透析前HCO3浓度与SCr、BUN、nPCR呈显著负相关(P<0.01),而与其他营养指标无明-显相关性。结论:透析前轻度MA在MHD患者中是常见的,可能与蛋白质的摄入量增加有关,轻度MA对透析充分的患者营养指标无明显损害作用。Objective To investigate the incidence of metabolic acidosis （MA）and its relationship with nutritional status in patients undergoing maintenance hemodialysis（MHD）. Methods 68 patients undergoing MHD were divided into MA group （40 cases, HCO3^- ≤ 21 retool/L） and non-MA group （28 cases, HCO3^- 〉 21 retool/L） according to their serum bicarbonate （HCO3^-） levels. The relationship of HCO3^- level with the nutritional parameters was analyzed in both groups. Results The incidence of MA was 58.8% in all the patients. The prehemodialytic levels of SCr, BUN, and nPCR were markedly higher in MA group than in non-MA group （P 〈 0.05）, while there were no significant differences between the two groups in Alb, PA, BMI and TSF. The prehemodialytic HCO3^- level was negatively correlated with serum SCr, BUN and nPCR （P 〈 0.01 ） but had no association with other nutritional parameters. Conclusions Mild MA is common in patients undergoing MHD, which may be a result of the increased protein intake, and does not affect the nutritional status in those patients.

关 键 词：酸中毒 营养不良 肾透析 

分 类 号：R591[医药卫生—内科学] R692.5[医药卫生—临床医学] R589