糖尿病与非糖尿病腹膜透析患者营养状况比较  

Comparison of nutritional status in peritoneal dialysis in patients with diabetes and non-diabetes

作　　者：王蕾[1] 陈孟华[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2008年第12期1094-1096,共3页Ningxia Medical Journal

基　　金：本课题由宁夏科技攻关项目(2001-022-03)基金资助

摘　　要：目的比较糖尿病与非糖尿病腹膜透析患者的营养状况,探讨糖尿病腹膜透析病人营养不良的影响因素。方法采用横断面研究方法调查了规律腹膜透析治疗3个月以上的52例患者的原发病因、营养状况、透析方案、残肾功能、超滤量、尿量、容量状况及其他一般情况等。结果①52例患者中,根据SGA评估,29例为营养不良,其中糖尿病连续性不卧床腹膜透析(CAPD)病人16例,糖尿病CAPD病人的营养不良发生率(88.90%)明显高于非糖尿病CAPD病人(38.20%),P<0.001。②与非糖尿病CAPD病人比较,糖尿病CAPD病人的血浆白蛋白、前白蛋白明显下降,CRP明显上升(P<0.05);握力明显下降(P<0.01);体重和平均动脉压明显增高(P<0.05);肌酐清除率及液体总清除量差异无统计学意义(P>0.05),但糖尿病组的透析液糖浓度、糖总量、总剂量均明显高于非糖尿病组(P<0.05);糖尿病CAPD病人水肿的发生率(94.44%)明显高于非糖尿病CAPD病人为47.06%,P<0.001。③糖尿病腹膜透析患者营养不良与水肿程度之间(r=0.611,P<0.0001)呈显著相关关系。结论糖尿病腹膜透析患者营养不良发生率明显高于非糖尿病者,主要与炎症发应及容量负荷过重有关。Objective To compare the nutritional status in diabetic and non - diabetic patients with peritoneal dialysis and to investigate its effects in diabetic patients. Methods In a cross - sectional study, 52 patients were treated with peritoneal dialysis for at least 3 months, the causes, nutritional status, dialysis prescription, peritoneal uhrafiltration, urine volume and fluid status were reviewed. Results （ 1 ） 52 patients were included in this study, of which 29 patients （55. 80% ） were malnourished ; among these 29 cases, 16 cases were diabetics. There was significantly higher morbidity of malnutrition in diabetics （88. 90% ） than in those non - diabetics （38. 20 % ） （P 〈0. 001 ）. （2） There was no significant difference in age, height, residual renal function and total fluid removal between diabetics and non - diabetics groups. However, in diabetics group the body weights, mean arterial pressure, dialysate doses, dialysate glucose load, peritoneal ultra filtration and CRP were significantly higher and ALB, Pre - A was Lower （ P 〈 0. 05 ）. There were significantly more edematous in diabetics group as compared to non -diabetics group （P 〈 0. 001 ）. （3） Malnutrition was positively correlated with edematous level （r = 0. 611, P 〈 0. 0001 ）. Conclusion The incidence of malnourished is much higher in diabetic peritoneal dialysis patients than that in non -diabetic peritoneal dialysis patients, which relates to inflammation and fluid overloading.

关 键 词：腹膜透析 营养不良 糖尿病 

分 类 号：R459.5[医药卫生—治疗学]