维持性血液透析的老年慢性肾脏病患者营养状况影响因素分析  

Analysis of influencing factors on nutritional status of elderly patients with chronic kidney disease received maintenance hemodialysis

作　　者：张世希 袁海川[1] 万里红[1] ZHANG Shixi;YUAN Haichuan;WAN Lihong(Department of Geriatric Nephrology,Jiangsu Provincial People’s Hospital,Jiangsu Province,Nanjing210000,China)

机构地区：[1]江苏省人民医院老年肾科,江苏南京210000

出　　处：《中国医药导报》2023年第6期86-89,共4页China Medical Herald

基　　金：江苏省“333工程”科研资助项目(BRA2017409)。

摘　　要：目的分析维持性血液透析的老年慢性肾脏病患者营养状况的影响因素。方法回顾性收集2020年3月至2022年4月江苏省人民医院收治的153例老年慢性肾脏病行维持性血液透析治疗患者的临床资料,根据是否出现营养不良将其分为营养不良组(84例)和营养正常组(69例),比较两组临床资料,采用多因素logistic回归模型分析患者出现营养不良的影响因素。结果营养不良组体重指数、基础代谢率及血清白蛋白(Alb)、血红蛋白(Hb)、前蛋白(PA)、肌酐水平均低于营养正常组,年龄、透析时间>12个月占比、尿素清除指数(Kt/v)<1.2占比、焦虑症状占比、抑郁症状占比及血尿素氮水平均高于营养正常组,差异有统计学意义(P<0.05)。多因素分析结果显示,年龄、透析时间>12个月、Kt/v<1.2、焦虑、抑郁及血清Alb、Hb、PA水平均为维持性血液透析的老年慢性肾脏病患者营养状况的影响因素(P<0.05)。结论年龄、血清Alb、Hb、PA水平、透析时间、Kt/v、有焦虑抑郁症状均为维持性血液透析的老年慢性肾脏病患者营养不良的影响因素,临床可据此对有以上特征的患者进行针对性治疗干预。Objective To analyze the influencing factors of nutritional status of elderly patients with chronic kidney disease received maintenance hemodialysis.Methods The clinical data of 153 elderly patients with chronic kidney disease received maintenance hemodialysis from March 2020 to April 2022 in Jiangsu Provincial People’s Hospital were retrospectively collected,and the patients were divided into the malnutrition group(84 cases)and the normal nutrition group(69 cases)according to whether malnutrition occurred.The clinical data of the two groups were compared,and the influencing factors of malnutrition were analyzed by multivariate logistic regression model.Results Body mass index,basal metabolic rate,serum albumin(Alb),hemoglobin(Hb),proprotein(PA),and creatinine levels in malnutrition group were lower than those in normal nutrition group,age,the proportion of dialysis time>12 months,the proportion of urea clearance index(Kt/v)<1.2,the proportion of anxiety symptoms,the proportion of depression symptoms,and the serum urea nitrogen level were all higher than those of normal nutrition group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that age,dialysis time>12 months,Kt/v<1.2,anxiety,depression,and serum Alb,Hb,PA levels were all factors influencing the nutritional status of elderly patients with chronic kidney disease received maintenance hemodialysis(P<0.05).Conclusion Age,serum Alb,Hb,PA levels,dialysis time,Kt/v,symptoms of anxiety,and depression are all influencing factors of malnutrition in elderly patients with chronic kidney disease received maintenance hemodialysis,clinical treatment or intervention can be carried out for patients with the above characteristics.

关 键 词：维持性血液透析 慢性肾脏病 老年 营养状况 影响因素 

分 类 号：R692[医药卫生—泌尿科学]