维持性血液透析患者营养评估和人体成分分析  

Assessment of nutritional status and body composition in hemodialysis patients

作　　者：章海芬[1] 陶幸娟 施翎 庞慧华[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肾内科,上海200127 [2]上海交通大学护理学院,上海200025

出　　处：《中国血液净化》2018年第2期114-117,共4页Chinese Journal of Blood Purification

基　　金：上海市卫计委项目20134095;上海市卫计委项目2015MS-B15

摘　　要：目的调查维持性血液透析(maintenance hemodialysis,MHD)患者的营养现状、人体成分分布及其影响因素。方法选择MHD患者123例,应用人体成分检测仪(body composition monitoring,BCM)、人体测量和生化指标评估患者营养和人体成分分布。结果 36.6%的MHD患者存在营养不良。营养不良组患者瘦组织指数(1ean tissue index,LTI)显著低于营养良好组(11.598±2.700比12.958±2.531,t=-2.801,P=0.006)。超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)升高是患者低瘦组织指数的独立危险因素(OR=2.431,95%CI=1.136~5.201,P=0.022);而握力是瘦组织指数的保护因素(OR=0.219,95%CI=0.097~0.497,P<0.001)。结论营养不良MHD患者的人体成分表现为瘦组织量不足。瘦组织量的下降可能与炎症有关;握力可作为MHD患者肌肉量下降的监测指标。Objective To investigate the nutritional status and body composition in maintenance hemodialysis（MHD） patients, and to explore the factors affecting the body composition. Methods A total of 123 MHD patients completed the body composition analyses by body composition monitoring（BCM）, and nutritional assessment by biochemical and anthropometric measurements. Results Malnutrition was defined in36.6% patients by prealbumin level. A significant difference Significant difference in lean tissue index（LTI）was noted between malnutrition group and well-nourished group, with lower LTI（11.598±2.700 vs. 12.958±2.531, t=-2.801, P=0.006） in patients in malnutrition group. Higher hypersensitive C-reactive protein（hsCRP） was identified as an independent risk factor for lower LTI（OR=2.431, 95% CI 1.136~5.201, P=0.022）,while handgrip strength was found to be a protective factor for LTI（OR=0.219, 95% CI 0.097~0.497, P〈0.001） in MHD patients. Conclusion Malnutrition patients tended to have lower lean tissue mass accompanied by higher inflammation markers. Handgrip strength could be used to monitor muscle mass in MHD patients.

关 键 词：血液透析 人体成分 营养 瘦组织 脂肪组织 

分 类 号：R473[医药卫生—护理学]