持续性非卧床腹膜透析患者营养状况及影响因素分析  

Analysis of nutritional status and influence factors on continuous ambulatory peritoneal dialysis

作　　者：刘大双[1] 梁莉[1] 梁艳[1] 

机构地区：[1]第三军医大学新桥医院肾内科,重庆400037

出　　处：《中国医学前沿杂志（电子版）》2015年第7期92-95,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者的营养状况及影响因素。方法选择2012年1月至2012年12月于本院行长期腹膜透析患者62例为研究对象,随访1年后,评价患者营养情况并对其可能的影响因素进行统计学分析。结果 CAPD患者透析前营养不良发生率为74.2%,透析后6个月和12个月患者血清白蛋白(Alb)、体质指数(BMI)、中臂肌围(MAMC)、肱三头肌皮褶厚度(TSF)等较透析前均明显改善(P<0.05),营养不良发生率分别为48.4%和29.0%,与透析前相比差异具有显著性(P<0.05)。对影响CAPD患者营养状况单因素分析初筛出9个相关因素,分别为年龄、抑郁程度、Alb水平、合并急性并发症、应用促红细胞生成素、残肾尿素清除指数(Kt/V)、蛋白质摄入量(DPI)、超敏C反应蛋白(hs-CRP)及HCO3-。多因素Logistic回归分析显示,合并急性并发症、Alb<20 g/L、DPI<0.5 g/(kg·d)和hs-CRP≥3 mg/L为CAPD患者发生营养不良的独立危险因素。结论合并急性并发症、Alb<20 g/L、DPI<0.5 g/(kg·d)和hs-CRP≥3 mg/L是CAPD患者发生营养不良的独立危险因素。因此建立科学的生活方式、加强对患者的个性化管理、关注患者的营养状况是提高其生活质量,降低营养不良发生率的重要手段。Objective To investigate the nutritional status and risk factors of（continuous ambulatory peritoneal dialysis, CAPD） patients. Method From January 2012 to December 2012, 62 patients with long-term peritoneal dialysis were selected as the research objects. After 1 year of follow-up, the nutritional status of the patients were evaluated and the possible influencing factors were statistically analyzed. Result The incidence rate of malnutrition of CAPD patients before hemodialysis was 74.2%, after 6 months and 12 months dialysis, Alb, BMI, MAMC, TSF and other nutritional indexes were significantly improved（P〈0.05）, the incidences of malnutrition were significantly improved, respectively 48.4% and 29.0%, the differences were statistically significant（P〈0.05）; 9 factors influence on the nutritional status of CAPD patients in univariate analysis were sieved out, respectively age, degree of depression, Alb level, acute complications, application of EPO, Kt/V, DPI, total hs-CRP and HCO3-, Logistic regression analysis of the 9 factors showed that with acute complications, Alb 〈20 g/L, DPI 〈0.5 g/（kg·d） and hs-CRP ≥ 3 mg/L were the independent risk factors of patients with malnutrition. Conclusion Combined with acute complications, Alb 〈20 g /L, DPI 〈0.5 g/（kg·d） and hs-CRP ≥ 3 mg/L are the independent risk factors for the CAPD patients malnutrition. Therefore, to establish a scientific way of life, strengthen the individual management, pay attention to the patient＇s nutritional status is an important means to improve their quality of life and reduce the incidence of malnutrition.

关 键 词：持续性非卧床腹膜透析 营养状况 影响因素 

分 类 号：R692.5[医药卫生—泌尿科学]