维持性血液透析患者营养不良的主要相关因素及其影响  

Analysis of main factors associated with malnutrition in maintenance hemodialysis patients

作　　者：马彬[1] 何永成[1] 栾韶东[1] 张懿韵[1] 徐艺[1] 余俊英[1] 

机构地区：[1]广东省深圳市第二人民医院肾内科,518035

出　　处：《临床内科杂志》2008年第6期405-407,共3页Journal of Clinical Internal Medicine

基　　金：深圳市科技计划科研项目资助(基金编号:JH200507120839A)

摘　　要：目的观察维持性血液透析患者营养不良的发生率及其严重程度,探讨引起该症的主要相关因素及其影响。方法维持性血液透析患者79例患者,其中男性56例,女性23例,平均年龄(46.3±4.1)岁、血液透析(28.9±9.2)个月。将患者分为三个对比组:血透充分性对比组、蛋白质饮食对比组和年龄对比组。测定血清白蛋白、前白蛋白、转铁蛋白、血红蛋白、尿素氮和肌酐。采用主观综合营养评估法进行主观评定,观察血液透析相关并发症和住院情况。结果营养不良发生率为34.18%。各组比较显示,血透不充分及非高蛋白饮食患者的营养不良发生率明显高于血透充分和高蛋白饮食对比组,低蛋白血症明显,每年平均住院次数/人增加,老年与中青年患者的营养状况对比则无明显差别。结论透析不充分和蛋白质摄入不足是引起维持性血液透析患者营养不良的主要的、独立的危险因素,二者同时存在更加重营养不良。高龄不是营养不良的主要因素。Objective To analyze occurrence and severity of malnutrition in maintenance hemodialysis （MHD） patients and its associated factors.Methods 79 cases of MHD patients,included 56 males,mean age of 46.3±4.1 years and mean hemodialsis duration of 28.9 ±9.2 months,were enrolled in this study and divided into 3 comparing groups：aged and non-aged group,adequate and inadequate dialysis group,high protein diet and low protein diet group,serum albumin and pre-albumin,transferrin,blood urea nitrogen（BUN）,creatinine were examined and objective subjective global-nutritional assessment（SGA）method was used.Hemodialysis related complications and admission time were recorded.Results Malnutrion were found in 34.18% patients.Rate of malnutrition was significantly higher in inadequate dialysis group and low protein diet group with low albuminemia and more admission times.There was no statistic difference of nutrition status between aged and non-aged group.Conclusion Inadequate dialysis and low protein intake were main independent risk factors of malnutrition in MHD patients.Age was not risk factor of malnutrition.

关 键 词：维持性血液透析 营养不良 透析充分性 蛋白质饮食 相关并发症 

分 类 号：R459.5[医药卫生—治疗学]