慢性肾脏病患儿营养状况及其影响因素分析  

Nutritional status and its influencing factors in children with chronic kidney disease

作　　者：宋家峰 李锡太[2] 王振江 

机构地区：[1]周口永兴医院,河南周口461400 [2]北京市疾病预防控制中心

出　　处：《华南预防医学》2017年第5期434-437,共4页South China Journal of Preventive Medicine

摘　　要：目的探讨慢性肾脏病(CKD)患儿的营养状况及发生营养不良的影响因素。方法以2002年美国国家肾脏病基金会制定的诊断标准,以2012年9月至2015年10月在周口永兴医院确诊为CKD的患儿为研究对象,对其身长、体质量等参数进行测量;采用WHO通用的Z值评分标准,对CKD患儿营养状况进行分析,并对研究对象的家长进行营养相关知识调查,对CKD患儿营养不良发生情况进行描述,并对营养不良发生影响因素进行分析。结果共纳入研究CKD患儿1 500例,年龄3~14岁,平均年龄为(8.7±3.5)岁,男、女分别为810、690例,男女性别比为1.17∶1。CKD病程平均(2.8±1.3)年,CKD分期为Ⅰ、Ⅱ、Ⅲ、Ⅳ期者分别有375、420、300、405例。共有878例CKD患儿出现营养不良,营养不良发生率为58.5%,其中生长迟缓230例、低体质量182例、消瘦466例。多因素分析结果显示,CKD患儿病程越长、分期越高,发生营养不良的可能性越大(OR=1.773、OR=1.598)。CKD患儿父母了解营养不良知识、接受过营养知识指导、知道营养素的概念、儿童进行过营养状况检查、关注儿童的饮食情况的调查对象发生营养不良的可能性较低(OR=0.598、0.472、0.603、0.617、0.392)。结论 CKD患儿营养不良发生率高,CKD分期越高、病程越长患儿发生营养不良的风险越高,家长多了解营养不良知识有助于降低患儿营养不良的发生率。Objective To investigate the nutritional status of children with chronic kidney disease （CKD） and the influencing factors of malnutrition. Methods According to the US National Kidney Foun- dation practice guidelines for CKD in 2002, children diagnosed with CKD in Yongxing Hospital, Zhoukou were recruited from September 2012 to October 2015 to participate in a nutritional survey. Their body height, body mass and other parameters were mearured. The nutritional status of CKD children was evalua- ted using the WHO generic Z value standard. Questionnaire survey of the knowledge related nutrition was conducted among parents of the children. The incidence of malnutrition in children with CKD and factors influencing the malnutrition were analyzed. Results A total of 1 500 children with CKD were enrolled in the study. Their age ranged from 3 to 14 years and the average age was （ 8.7 ± 3.5 ） years. Of all the children with CKD, 810 were male and 690 female, with a male to female ratio of 1.17： 1. Average dura- tion of CKD was （2.8 ± 1.3 ） years, and there were 375 cases in Stage I CKD, 420 in Stage 2 CKD, 300 in Stage 3 CKD, and 405 in Stage 4 CKD. There were 878 CKD cases with malnutrition and the incidence of malnutrition was 58.5%. Of them, 230 cases were growth retardation, 182 were low body mass, and 466 were emaciated. Multivariate logistic regression analysis showed that CKD children with longer duration （ OR = 1. 773 ） and higher CKD stages （ OR = 1. 598 ） were more likely to have malnutrition. The children with CKD, whose parents understood malnutrition knowledge （ OR = 0.598 ） , received nutrition knowledge guidance （ OR = 0.472）, knew the concept of nutrients （ OR = 0.603 ）, had their children nutritional sta- tus checked （OR =0. 617）, and concerned about the children＇s diet （OR = 0. 392）, were less likely to suffer from malnutrition. Conclusion The incidence of malnutrition in children with CKD was high. The higher the CKD stage and the longer the course of disease

关 键 词：肾病 营养不良 因素分析 统计学 

分 类 号：R153.2[医药卫生—营养与食品卫生学]