应用生物电阻抗法评估44例维持性血液透析患者的营养状况  

Evaluation of nutrition status among 44 maintenance hemodialysis patients by bioelectrical impedance analysis

作　　者：王婷立[1] 柳园[2] 胡雯[2] 石运莹[1] 

机构地区：[1]四川大学华西医院肾脏内科,成都610041 [2]四川大学华西医院临床营养科,成都610041

出　　处：《中国血液净化》2015年第11期640-643,共4页Chinese Journal of Blood Purification

摘　　要：目的探讨生物电阻抗法(bioelectric impedance analysis,BIA)人体成分测量在评价透析患者营养状态中的作用。方法选择2014年6月至12月在我院进行维持性血液透析患者,共44例,应用BIA法进行体成分测量、体质量指数(body mass index,BMI)和实验室检查等指标评价患者营养状态。结果患者平均BMI为23.12%±3.51,9.1%的患者存在营养不良;实验室检查显示患者平均白蛋白(ALB)为(41.75±6.34)g/L、胆固醇(TC)为(3.60±0.93)mmol/L、甘油三酯(TG)为(1.23±0.85)mmol/L、尿酸(UA)为(402.56±85.99)mmol/L,其中低于正常的患者分别为29.5%、15.9%、2.3%及2.3%;应用BIA对MHD患者进行营养状况评估,营养不良(含营养不良风险)的发生率为45.5%。研究比较了几种评估MHD患者营养不良及营养不良风险发生率的方法,BIA法与使用白蛋白检测相比较无显著统计学差异(P=0.123),但明显高于用BMI(P=0.000)、TC(P=0.003)、TG(P=0.000)、UA(P=0.000)检测的检出率。我们对31例(70.5%)血清白蛋白处于正常参考值范围的患者的BIA数据进行分析,发现其中12例(38.7%)患者的身体细胞总量(body cell mass,BCM)结果仍提示营养不良。结论生物电阻抗法人体成分测量可更早发现维持性血液透析患者的营养不良,具有无创、安全、可重复性强的优点,值得临床推广应用。Objective The purpose of this study was to discuss the application ofbioelectric impedance analysis （BIA） in the evaluation of nutrition status among patients with maintenance hemodialysis （MHD）. Methods Forty-four MHD patients in our hospital from Jun. to Dec., 2014 were enrolled in this study. Nutri- tion status of the patients was evaluated by BIA method, body mass index （BMI）, and laboratory tests. Re- suits The average BMI was 23.12±3.51, and 9.1% of the patients were at the risk of malnutrition. The labora- tory tests showed that serum albumin, cholesterol, triglyceride and uric acid were 41.75 ±6.34g/L, 3.60± 0.93mmol/L, 1.23m0.85mmol/L and 402.56±85.99mmol/L, respectively. Serum albumin, cholesterol, triglycer- ide and uric acid below normal ranges were found in 29.5%, 15.9%, 2.3% and 2.3%, respectively of the 44 pa- tients. The ratio of malnutrition evaluated by BIA was 45.5%, similar to the ratio evaluated by serum albumin （P---0.123） but significantly higher than that by BMI （P=-0.000）, total cholesterol （P=0.003）, triglyceride （P= 0,000）, and uric acid （P=-0.000）. In the 31 patients with normal serum albumin level, 12 cases （38.7%） were found to have lower body cell mass （BCM） suggesting malnutrition by BIA. Conclusion BIA can evaluate human body composition and detect malnutrition status earlier than other methods in MHD patients. BIA is a noninvasive, safe and stable method useful for nutrition evaluation in MHD patients.

关 键 词：生物电阻抗 维持性血液透析 营养 不良 

分 类 号：R318.16[医药卫生—生物医学工程]