三种方法对血液透析患者营养评估及影响因素比较分析  

To Assessment Nutritional Status on Hemodialysis Patients and Analysize its Influencing Factors by Three Methods

作　　者：唐宽平 董哲毅[1] 张智敏[2] 李博[2] 赵华[2] 陈香美[1] 张利[1] TANG Kuanping;DONG Zheyi;ZHANG Zhimin(Department of Nephrology,Chinese PLA General Hospital Beifing,Chinese PLA Institute of Nephrology,State Key Laboratory of Kidney Diseases,National Clinical Research Center for Kidney Diseases,Beijing（100853;Outpatient Department of ZHAN Tansi,Chinese PLA 309 Hospital,Beijing（100034)

机构地区：[1]中国人民解放军总医院肾脏病科,解放军肾脏病研究所,肾脏疾病国家重点实验室,国家慢性肾病临床医学研究中心,北京100853 [2]解放军第309医院旃坛寺门诊部,北京100034

出　　处：《中国中西医结合肾病杂志》2018年第8期677-681,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：“973”计划项目(No.2015CB553605);国家自然科学基金青年科学基金资助项目(No.81700629)

摘　　要：目的:对维持性血液透析(MHD)患者进行蛋白质能量消耗(PEW)评估并分析比较,为临床诊疗提供依据。方法:横断面及回顾性研究。运用透析营养客观评分(OSND)、改良定量主观整体评估法(MQSGA)、人体成分分析(BCM)结合问卷调查、人体测量、生化指标对MHD患者进行营养评估及行相关性分析、自身影响因素分析。结果:348例MHD患者OSND、MQSGA、BCM评估营养不良发生率分别为79. 3%、67. 2%、42. 2%,男、女患者多项营养指标差异存在统计学意义(P <0. 05);三种方法相关性显著的营养指标及自身影响因素各有异同,MAC是共同的影响因子,评估PEW及炎症效能由高到低分别是OSND、MQSGA、BCM。结论:MHD患者普遍存在PEW,男、女性患者营养存在差异; OSND是评估PEW的敏感工具,OSND、MQSGA联合BCM,能更全面评估MHD患者营养状况,为临床工作提供准确的依据。Objective： To evaluate Protein-energy wasting on maintenance hemodialysis patients（MHD）,to analysis and compairs,provide the basis for clinical diagnosis and treatment. Methods： Cross-sectional and retrospective study. To assess nutrition on MHD patients,correlation analysis and analysis of its influencing factors by objective score of nutrition on dialysis（OSND）,modified quantitative subjective global assessment（MQSGA）,body composition monitor（BCM） combined with questionnaire,anthropometrics,laboratory assays. Results： The incidence of PEW of 348 MHD patients was 79. 3%,67. 2%,42. 2%,there were significant differences in many nutrition indicators between male and female（P〈0. 05）. the correlation of nutrition indicators and influencing factors of three evaluation method are different,MAC is a common factors,to evaluate the PEW and inflammatory effectiveness from high to low were OSND,MQSGA,BCM. Conclusion： Our data indicate that PEW is wide spread in dialysis patients,there were differences in nutrition between male and female,OSND is a sensitive tool for assessing PEW in MHD patients. OSND,combined with MQSGA,BCM,can more comprehensive evaluate nutrition status of MHD patients,provides the accurate basis for the clinical work.

关 键 词：维持性血液透析 蛋白质-能量消耗 透析营养客观评分 改良定量主观评估法 人体成分分析 

分 类 号：R692.5[医药卫生—泌尿科学]