腹膜透析患者营养状况与衰弱的横断面研究  

A cross-sectional study on nutritional status and frailty of peritoneal dialysis patients

作　　者：谢应业 陈丽[1] 谢娜 单海珍 赵凤仙 曹锐[2] 尹良红[2] 苏晓燕[1] XIE Yingye;CHEN Li;XIE Na;SHAN Haizheng;ZHAO Fengxian;CAO Rui;YIN Lianghong;SU Xiaoyan(Department of Nephrology,Dongguan Tungwah Hospital,Dongguan 523000,China;Department of Nephrology,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]东莞东华医院肾内科,广东东莞523000 [2]暨南大学附属第一医院肾内科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2021年第4期384-389,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广东省科技厅基金项目(507204531040);东莞市社会科技发展重点项目(2018507150461629);东莞市社会科技发展一般项目(201850715046831)。

摘　　要：目的:调查腹膜透析(腹透)患者的营养状况及衰弱情况,评价透析龄及蛋白能量摄入与营养不良关系,评估营养不良与衰弱关系.方法:对52例持续不卧床腹膜透析患者采用营养不良炎症评分量表及心血管健康研究量表分别评估其营养情况及衰弱情况.根据营养不良炎症评分分为营养正常组及营养不良组,比较两组之间的体脂率、肌肉量、生化指标、人体学测量指标、膳食情况、透析龄及衰弱率.结果:根据营养不良炎症评分,52例腹透患者中营养正常19例,中度营养不良29例,重度营养不良4例;根据心血管健康研究量表评分,49例腹透患者25人处于衰弱前期,24人无衰弱.营养正常组与营养不良组相比:肱三头肌肌围更大,肌肉含量更高,体质量指数、血红蛋白、白蛋白、前白蛋白、总铁结合力更高,差异有统计学意义(P<0.05).两组的皮下脂肪、总胆固醇、甘油三酯差异无统计学意义(P>0.05).透析龄越长,患者营养不良发生率越高;两组的蛋白、能量摄入均未达标,蛋白摄入两组间无统计学差异(P=0.190),但营养正常组能量摄入高于营养不良组,差异有统计学意义(P=0.017).两组间的衰弱前期发生率无统计学差异(P=0.769).结论:腹透患者营养不良发生率及衰弱前期发生率高,透析龄长与营养不良发生率高度相关,腹透患者普遍存在蛋白能量摄入不足,两组间衰弱前期发生率无统计学差异.Objective:To investigate the nutritional and frailty status of peritoneal dialysis patients,evaluating the relationship between dialysis age and protein-energy intake and malnutrition and the relationship between malnutrition and frailty.Methods:Nutritional status and frailty were assessed by malnutrition inflammation score scale(MIS)and cardiovascular health study scale among 52 peritoneal dialysis patients.According to the malnutrition inflammation score scale,participants were divided into normol group and malnutrition group based on the result of MIS.Body fat rate,muscle mass,biochemical test result,anthropological measurement,dialysis age,frailty rates between the two groups were compared.Results:According to MIS,there were 19 normal nutrition patients,29 moderate malnutrition patients and 4 severe malnutrition patients among 52 peritoneal dialysis patients.According to CHS,there were 25 pre-frailty patients,24 patients with no frailty among 49 patients.Compared with the malnutrition group,the normal group had longer mid-arm muscle circumference,heavier muscle mass,higher body mass index,hemoglobin,albumin and prealbumin and total iron binding capacity(P<0.05).There was no significant difference in triceps skin-fold thickness,total cholesterol and triglyceride(P>0.05)between two group.The incidence of malnutrition increased with the extension of dialysis age.Neither the groups reached protein-energy intake standard,and there was no significant difference in protein intake between the two groups(P=0.190).However the energy intake of normal nutrition group was higher than that of malnutrition group,and the difference was significant(P=0.017).There was no significant difference in pre-frailty rates between the two groups(P=0.769).Conclusion:The malnutrition rates and pre-frailty rates was high in peritoneal dialysis patients,and the dialysis age was highly correlated with malnutrition.Peritoneal dialysis patients generally had insufficient protein-energy intake,while there were no significant difference in pre-

关 键 词：腹膜透析患者 营养不良 蛋白能量摄入 衰弱 

分 类 号：R692.5[医药卫生—泌尿科学]