糖尿病肾病腹膜透析病人营养状况的调查  

INVESTIGATION OF THE NUTRITIONAL STATUS IN PATIENTS WITH DIABETIC NEPHROSIS UNDERGOING PERITONEAL DIALYSIS

作　　者：万美燕[1] 陈建民[1] 夏平[1] 

机构地区：[1]青岛市市立医院肾内科,青岛266011

出　　处：《齐鲁医学杂志》2002年第1期37-38,共2页Medical Journal of Qilu

摘　　要：①目的　前瞻性观察 2型糖尿病肾病腹膜透析 (PD)病人的营养状况及影响因素。②方法　采用主观整体营养评估法结合有关检查综合判断病人的营养状况。③结果　 2 8例病人中营养良好者 8例 ,轻中度营养不良者 15例 ,重度营养不良者 5例。营养不良者清蛋白 (ALb)、前清蛋白 (Pre A)、肌酐 (Scr)均明显低于营养良好者(F =4 .0 8～ 5 .2 2 ,q =3.6 4～ 5 .11,P <0 .0 5 ) ,营养不良者每日蛋白摄取量 (DPI)、蛋白分解率 (nPCR)明显低于营养良好者 (F =4 .32 ,5 .11,q=3.83～ 6 .31,P <0 .0 5 )。透析时间大于 180d者营养不良发生率明显大于透析时间小于 180d者 (χ2 =7.6 5 ,P <0 .0 0 1) ,重度营养不良者尿素清除指数 (KT/V)、肌酐清除率 (Ccr)、残存内生肌酐清除率 (RRF)明显低于营养良好者和轻中度营养不良者 (F =3.0 6 ,3.17,q =5 .71～ 9.76 ,t =5 .89,P <0 .0 1)。 ④结论糖尿病肾病腹膜透析病人营养不良发生率较高 ,此与清蛋白摄入不足、胃肠道消化吸收功能减退、糖尿病本身高分解、透析时间、透析前营养状况、残余肾功能等因素有关。Objective\ A prospective study was made to observe the nutritional status and its affecting factors in patients with diabetic nephrosis treated with peritoneal dialysis.\ Methods\ Subjective general assessment(SGA) and related examinations were used to assess their nutritional status.\ Results\ In 28 patients investigated, 8 patients(29%) were graded as good nutrition; 15(53%), mild malnutrition and 5(18%), severe malnutrition. The levels of albumin(ALB), prealbumin(PreA) and creatinine(Cr) in patients with malnutrition were markedly lower than those in patients with good nutrition( F=4.08-5.22,q=3.64-5.11, P <0.05), the daily protein intake and protein catabolic rate were also lower than those with good nutrition( F=4.32,5.11, q=3.83-6.31,P <0.05). The malnutrition rate was higher in patients who received dialysis for over 180 days than that in patients dialysed less than 180 days( χ 2=7.65, P <0.01). The KT/V, creatinine clearance, residual function were much lower in patients with severe malnutrition than those in patients with good nutrition and mild malnutrition( F=3.06,3.17, q=9.76,5.71, 8.65 ,7.45, t=5.89,P <0.01).\ Conclusion\ There was a high morbidity of malnutrition in patients with diabetic nephrosis who underwent peritoneal dialysis. This morbidity may have something to do with low protein intake, deterioration of digestive and absorptive functions of gastrointestinal system, highly analytical metabolism, duration of dialysis, nutrition status before peritoneal dialysis and residual renal function.

关 键 词：糖尿病肾病 腹膜透析 营养调查 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]