维持性血液透析患者人体成分分析评估营养状况  

Body composition analyses for the evaluation of nutritional status in maintenance hemodialysis patients

作　　者：余毅[1] 刘书凤[1] 王琰[1] 林曰勇[1] 陈今[1] 孙淑清[1] 

机构地区：[1]南京军区福州总医院(福建医科大学福总临床医学院)血液净化科,福州350025

出　　处：《中国血液净化》2016年第6期353-356,共4页Chinese Journal of Blood Purification

摘　　要：目的分析维持性血液透析(maintenance hemodialysis,MHD)患者人体成分,评估营养状况。方法选择MHD患者57例,应用人体成分分析仪(Body composition monitor,BCM)测量人体成分,检测患者透析前血清总胆固醇、三酰甘油、白蛋白、血红蛋白、血肌酐等生化指标,以体质量指数(body mass index,BMI)、单位体表面积脂肪含量、瘦组织含量的均值分组进行比较及相关分析。结果BMI高组(BMI≥21.68kg/m^2)与BMI低组(BMI<21.68 kg/m^2)比较,前者单位面积脂肪组织含量较高(t=4.327,P<0.001),BMI与单位面积脂肪含量呈正相关(r=0.588,P<0.001)。2组单位面积瘦组织含量差异无统计学意义(t=0.892,P=0.376),BMI与单位面积瘦组织含量不存在直线相关(r=-0.109,P=0.419)。单位面积脂肪含量高组(≥12.29 kg/m^2)与单位面积脂肪含量低组(<12.29 kg/m^2)比较,前者胆固醇(t=2.882,P=0.006)、三酰甘油(t=2.040,P=0.047)、血红蛋白(t=3.857,P<0.001)均高于后者;单位面积脂肪含量与胆固醇(r=0.370,P=0.010)、三酰甘油(r=0.403,P=0.005)、血红蛋白(r=0.405,P=0.002)呈正相关。单位面积瘦组织含量高组(≥22.80 kg/m^2)与单位面积瘦组织含量低组(<22.80 kg/m^2)比较,前者血肌酐(t=2.515,P=0.015)、血清白蛋白(t=2.189,P=0.033)均高于后者;单位面积瘦组织含量与血肌酐(r=0.416,P=0.001)、白蛋白(r=0.315,P=0.018)呈正相关。结论 BCM能简便、准确、无创地评估MHD患者人体成分,有效评估营养状况。Objective To assess the nutritional status by body composition monitor （BCM） in maintenance hemodialysis （MHD） patients. Method A total of 57 MHD patients were enrolled in this study. Their body composition and laboratory data were measured and collected. Patients were divided into 2 groups according to the mean value of BMI. Fat and muscle content per body surface unit and laboratory data were then compared between the 2 groups. Result Fat content per body surface unit was higher in the high BMI group （BMI 〉121.68 kg/m2） than in the BMI low group （BMI 〈21.68 kg/m2） （t=4.327, P〈0.001）; univariate regression analysis found that BMI value was positively correlated with fat content per body surface unit （1=0.588, P〈0.001）. The difference in muscle content per body surface unit between high BMI group and low BMI group was statistical insignificant （t=-0.892, P=-0.376）, and BMI value had no linear correlation with muscle content per body surface unit （z=-0.109, P=0.419）. Cholesterol （t=-2.882, P=0.006）, triglyceride （t=-2.040, P= 0.047） and hemoglobin （t=3.857, P〈0.001） were higher in the high fat content per body surface unit （≥12.29 kg/m2） group than in the low fat content per body surface unit （〈12.29 kg/m2）; fat content per body surface unit was positively correlated with cholesterol （r=0.370, P=0.010）, triglyceride （t=0.403, P=0.005） and hemoglobin （r=0.405, P=-0.002） levels. Serum creatinine （t=2.515, P=0.015） and albumin （t=2.189, P=0.033） were higher in the high muscle content per body surface unit group （≥22.80 kg/m2） than in the low muscle content per body surface unit group （〈22.80 kg/m2）; muscle content per body surface unit was positively correlated with serum creatinine （r=0.416, P=0.001） and albumin （1=0.315, P=0.018）. Conclusion The nutritional status in MHD patients could be conveniently and accurately assessed by BCM.

关 键 词：生物电阻抗 人体成分 BMI 维持性血液透析 

分 类 号：R318.16[医药卫生—生物医学工程]