体细胞质量指数与维持性血液透析患者蛋白质能量消耗的相关性研究  

Relationship between body cell mass index and protein energy wasting in maintenance hemodialysis patients

作　　者：彭玥 龙艳君[2] 周朝敏[2] 査艳 彭红英 PENG Yue;LONG Yan-jun;ZHOU Chao-min;ZHA Yan;PENG Hong-ying(Guizhou Medical University,Guiyang 550004,China.)

机构地区：[1]贵州医科大学,贵州贵阳550004 [2]贵州省人民医院肾内科,贵州贵阳550002 [3]贵州医科大学附属白云医院肾内科,贵州贵阳550014

出　　处：《中国实用内科杂志》2020年第7期571-575,共5页Chinese Journal of Practical Internal Medicine

基　　金：贵州省科技合作计划[黔科合LH字(2016)7151]。

摘　　要：目的探讨体细胞质量指数(BCMI)与维持性血液透析(MHD)患者蛋白质能量消耗(PEW)之间的关系。方法收集2018年6月至8月贵州省13家血液透析中心MHD患者的一般资料、人体物理测量指标、生化指标,并用生物电阻抗分析仪进行人体成分分析,通过体细胞质量(BCM)/身高2计算出BCMI。根据MHD患者是否发生PEW将所有研究对象分为两组,比较两组之间的差异。根据BCMI四分位数将所有研究对象分为(G1,G2,G3,G4)4组,并采用Logistic回归分析不同BCMI水平与MHD患者PEW发病的关系,进一步利用ROC曲线评估BCMI是否对PEW具有预测价值。结果共纳入研究对象1882例。利用Logistic回归分析,BCMI与MHD患者PEW发病风险有关,G1组MHD患者的PEW发病风险为G4组患者的2.75倍(95%CI 1.77~4.28 P<0.05),校正年龄、性别后,G1组PEW发病风险为G4组患者的2.69倍(95%CI 1.67~4.35 P<0.05),进一步校正年龄、性别、糖尿病、高血压后,G1组PEW发病风险为G4组患者的2.17倍(95%CI 1.17~4.01 P<0.05)。采用受试者工作特征曲线(ROC曲线)分析提示,BCMI可用于预测MHD患者PEW的发生,最佳预测阈值为8.56,曲线下面积为0.61(95%CI 0.57~0.65 P=0.021)。结论 BCMI与MHD患者PEW的发生有关,对MHD患者PEW发病有预测价值。Objective To explore the relationship between body cell mass index(BCMI)and Protein Energy Wasting(PEW)in maintenance hemodialysis(MHD)patients. Methods Clinical data,physical parameters,biochemical data and body composition data of MHD patients who were treated between June and August 2018 in 13 hemodialysis centers in Guizhou Province were assessed. BCMI was calculated by BCM. The patients were divided into two groups:PEW group and non-PEW group. In addition,the patients were divided into four groups according to the quartile of BCMI. Logistic regression models were used to analyze the relationships between BCMI and the occurance of PEW. The receiver operating characteristic curves(ROC)was applied to evaluate the predictive value of BCMI for PEW. Results Totally 1882 MHD patients were enrolled.Logistic regression analysis showed that the occurance of PEW was correlated with BCMI in MHD patients. The risk of PEW within MHD G1 group was 2.75 fold higher than that of the G4 group(95% CI 1.77-4.28,P<0.05). After adjustment for patients’ age and gender,the risk of G1 group was 2.69 fold higher than that of G4 group(95% CI 1.67-4.35,P<0.05).After adjustment for patients’ age,gender,DM history and hypertension history,the risk of G1 group was 2.17 fold higher than that of G4 group(95% CI 1.17-4.01,P<0.05). Receiver operating characteristic(ROC)analysis showed that BCMI could predict the development of PEW with an optimal threshold of 8.56 and the area under curve was 0.61(95%CI 0.57-0.65,P<0.021). Conclusions PEW in MHD patients is associated with BCMI, which exhibits the predictive value for PEW.

关 键 词：体细胞质量指数 维持性血液透析 蛋白质能量消耗 

分 类 号：R459.5[医药卫生—治疗学]