老年透析患者营养状况与胃肠道症状关系研究  

Study on the Relationship Between Nutritional Status and Gastrointestinal Symptoms of Elderly Dialysis Patients

作　　者：第加美 齐金秋 万秀娟 谢伟楠 胡耀娣 闫瑜 刘智 赵沨 DI Jiamei;QI Jinqiu;WAN Xiujuan;XIE Weinan;HU YaodiYAN Yu;LIU Zhi;ZHAO Feng(Department of Nephrology,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan Anhui 232000,China;Department of Pharmacy,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan Anhui 232000,China;Department of Breast Surgery,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan Anhui 232000,China)

机构地区：[1]安徽理工大学第一附属医院肾脏内科,安徽淮南232000 [2]安徽理工大学第一附属医院药学部,安徽淮南232000 [3]安徽理工大学第一附属医院甲乳外科,安徽淮南232000

出　　处：《安徽理工大学学报（自然科学版）》2023年第2期91-97,共7页Journal of Anhui University of Science and Technology:Natural Science

基　　金：安徽省教育厅重点研究项目(KJ2019A0094);安徽省教育厅重点研究项目(KJ2019A0095);蚌埠医学院科研课题计划项目(BYKY2019318ZD)。

摘　　要：目的探讨老年终末期肾病(ESRD)患者行透析治疗营养状况与胃肠道症状间关系。方法研究选取门诊病情稳定、年龄>60岁ESRD透析患者共94例,采用GSQ量表评估胃肠道症状严重程度,并据此分为轻度(21例)、中度(25例)及重度(39例)3组;营养状况评估采用MIS量表,同时测量体重、三头肌皮褶厚度、上臂围、上臂肌肉围、肌力、实验室生化指标及能量营养摄入指标。结果老年ESRD透析患者中合并胃肠道症状比例为90.43%(85/94),症状以便秘、腹痛及恶心为主;血液透析和腹膜透析患者MIS量表评分比较差异无显著性(P>0.05);重度胃肠道症状组MIS量表评分均显著高于无胃肠道症状、轻度胃肠道症状及中度胃肠道症状(P<0.05);中度胃肠道症状组每公斤体重摄入蛋白量显著低于轻度和重度胃肠道症状组(P<0.05);中度胃肠道症状组血肌酐(Cr)水平显著高于轻度和重度胃肠道症状组(P<0.05);但不同组胃肠道症状组其他营养状态相关指标比较差异无显著性(P>0.05);单因素分析结果显示,Cr和每公斤体重摄入蛋白量是胃肠道症状可能影响因素;多因素分析显示,每公斤体重摄入蛋白量是胃肠道症状的独立影响因素(β=1.122,SE=0.294,Waldχ^(2)=6.364,OR=3.543,95%CI=1.106~5.784,P<0.05)。结论老年ESRD透析患者合并胃肠道症状比例较高,这一症状出现与透析类型无关;同时胃肠道症状严重程度与MIS量表评分有关,但并不受其他营养相关指标、实验室生化指标及能量营养摄入指标的影响。Objective To investigate the correlation between nutritional status and gastrointestinal symptoms of elderly patients with end-stage renal disease undergoing dialysis.Methods 94 patients with end-stage renal disease and dialysis for aged>60 years in Outpatient Department were selected.The severity of gastrointestinal symptoms were assessed by GSQ questionnaire.They were divided into three groups:mild degree(23 cases),moderate degree(27 cases)and severe degree(44 cases).The nutritional status were assessed by MIS scale,and the body weight,BMI,triceps skin fold thickness,upper arm circumference,upper arm muscle circumference,muscle strength and laboratory biochemical indicators,energy and nutrition intake indicators and bioelectrical impedance indicators were measured.Results The proportion of gastrointestinal symptoms was 90.43%(85/94)in elderly patients with end-stage renal disease.The main symptoms included constipation,abdominal pain and nausea.There was no correlation between gastrointestinal symptoms and dialysis types in elderly patients with end-stage renal disease(P>0.05).The severity of gastrointestinal symptoms were correlated with the score of MIS scale(P<0.05),but there was no correlation between the severity of gastrointestinal symptoms and body weight,BMI,triceps skin fold thickness,upper arm circumference,upper arm muscle circumference,muscle strength,laboratory biochemical index,energy and nutrition intake index and bioelectrical impedance index(P>0.05).The results of univariate analysis showed that Cr and protein intake per kilogram of body weight were the possible influencing factors of gastrointestinal symptoms(P<0.05).Multivariate analysis showed that protein intake per kilogram of body weight was an independent factor for gastrointestinal symptoms(β=1.122,SE=0.294,Waldχ^(2)=6.364,OR=3.543,95%CI=1.106~5.784,P<0.05).Conclusion The proportion of gastrointestinal symptoms in elderly patients with end-stage nephropathy dialysis were higher,which had nothing to do with the type of dialysis.Meanwhi

关 键 词：老年 ESRD 透析 营养状况 胃肠道症状 

分 类 号：R692.5[医药卫生—泌尿科学]