腹膜透析患者衰弱与营养状态的相关性研究  

Correlation between frailty and nutritional status in patients undergoing peritoneal dialysis

作　　者：陈晶晶 易春燕[1,2] 林建雄[1,2] 毛海萍[1,2] 阳晓[1,2] CHEN Jingjing;YI Chun-yan;LIN Jian-xiong;MAO Hai-ping;YANG Xiao(Department of Nephrology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;NHC Key Laboratory of Clinical Nephrology(Sun Yat-Sen University)and Guangdong Provincial Key Laboratory of Nephrology,Guangzhou,510080,China)

机构地区：[1]中山大学附属第一医院肾内科,广州510080 [2]中山大学国家卫生健康委员会肾脏病临床研究重点实验室,广州510080

出　　处：《中国血液净化》2023年第11期831-835,共5页Chinese Journal of Blood Purification

基　　金：广东省肾脏病重点实验室运行经费(2020B1212060028);广东省医学科研基金项目(A2019394)。

摘　　要：目的探讨维持性腹膜透析(peritoneal dialysis,PD)患者衰弱与身体成分及营养状态的相关关系。方法横断面调查单中心规律随访的PD患者。采用临床衰弱量表评估患者的躯体功能状态、生物电阻抗仪测定患者的身体成分,收集患者的人口学资料及临床数据,分析PD患者发生衰弱的影响因素。结果共纳入528例PD患者,127例(24.1%)存在衰弱,与非衰弱组患者比较,衰弱患者具有较高的体脂肪量(t=4.148;P<0.001)、肥胖程度(t=2.629;P=0.009)、体质量指数(t=2.389;P=0.017)及浮肿指数(t=6.588;P<0.001),较低的骨矿物质量(t=-2.417;P=0.016)、骨骼肌量(t=-3.706;P<0.001)、细胞内液量(t=-3.714;P<0.001)、总体液量(t=-2.947;P=0.003)、瘦体质量指数(t=-2.245;P=0.025)、血清总蛋白(t=-2.486,P=0.013)、白蛋白(t=-6.329;P<0.001)及前白蛋白水平(t=-7.638;P<0.001)。多因素二元Logistic回归分析显示较高年龄(OR=1.130,95%CI:1.076~1.186;P<0.001)、较高的查尔森合并症得分(OR=1.599;95%CI:1.206~2.119,P<0.001)及收缩压(OR=1.043,95%CI:1.017~1.070,P<0.001)、较低的舒张压(OR=0.939,95%CI:0.898~0.981,P=0.005)及血清白蛋白水平(OR=0.858,95%CI:0.780~0.944,P=0.002)是PD患者发生衰弱的独立危险因素。结论本研究PD患者衰弱的发生率为24.1%。PD患者的瘦体质量指数、肥胖程度及浮肿指数与衰弱具有相关性。营养状态、老年、合并症及血压水平是PD患者发生衰弱的独立影响因素。Objective To investigate the relationship between frailty and body composition and nutritional status in maintenance peritoneal dialysis(PD)patients.Methods A cross-sectional survey of PD patients with regular follow-up in a single center was conducted.Clinical frailty scale was used to evaluate the physical function of the patients,and the Inbody720(Biospace)bioelectrical impedance meter was used to determine the body composition of the patients.The demographic and clinical data of the patients were collected.The influencing factors for frailty in PD patients were analyzed.Results A total of 528 PD patients were included,of which 127(24.1%)had frailty.Compared with the non-frailty group,frailty patients had higher body fat mass(t=4.148,P<0.001),obesity degree(t=2.629,P=0.009),body mass index(t=2.389,P=0.017)and edema index(t=6.588,P<0.001),and lower bone mineral mass(t=-2.417,P=0.016),skeletal muscle mass(t=-3.706,P<0.001),intracellular fluid volume(t=-3.714,P<0.001),total fluid volume(t=-2.947,P=0.003),lean body mass index(t=-2.245,P=0.025),serum total protein(t=-2.486,P=0.013),albumin(t=-6.329,P<0.001)and prealbumin(t=-7.638,P<0.001).Multivariate binary logistic regression analysis showed that older age(OR=1.130,95%CI:1.076~1.186,P<0.001),higher Charlson comorbidities score(OR=1.599,95%CI:1.206~2.119,P<0.001),higher systolic blood pressure(OR=1.043,95%CI:1.017~1.070,P<0.001),lower diastolic blood pressure(OR=0.939,95%CI:0.898~0.981,P=0.005)and lower serum albumin(OR=0.858,95%CI:0.780~0.944,P=0.002)were the independent risk factor for frailty in PD patients.Conclusions The incidence of frailty in PD patients was 24.1%.Lean body mass index,obesity degree and edema index were correlated with frailty.Nutritional status,older age,comorbidities and blood pressure were the independent influencing factors for frailty in PD patients.

关 键 词：腹膜透析 衰弱 身体成分 营养状态 

分 类 号：R459.5[医药卫生—治疗学]