全血微量元素与维持性血液透析患者食欲下降的关系分析  

Analysis of the relationship between whole blood trace elements and appetite loss in maintenance hemodialysis patients

作　　者：邹得娥 刘云 许世林 黎淑婷 陈文璇 刘岩 钟小仕 梁威锋 ZOU De-e;LIU Yun;XU Shi-lin(Guangzhou Red Cross Hospital Affiliated to Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学附属广州市红十字会医院,510220

出　　处：《中国现代药物应用》2024年第4期1-6,共6页Chinese Journal of Modern Drug Application

摘　　要：目的探讨全血微量元素与维持性血液透析(MHD)患者食欲下降的关系。方法120例行MHD患者,收集患者基本资料、生化指标和透析相关指标,测定透析前全血锰、锌、铜、硒和铅水平。根据简化营养食欲调查表(SNAQ)评分将患者分为食欲较好组(SNAQ评分≥14分,99例)和食欲下降组(SNAQ评分<14分,21例),比较两组基础资料、实验室检验结果、治疗方案,应用单因素和多因素二元Logistic回归模型分析MHD患者食欲的影响因素。结果两组患者年龄、透析龄、体质量指数和原发病比较差异均无统计学意义(P>0.05);食欲下降组女性患者占比76.2%高于食欲较好组的38.4%,差异具有统计学意义(P<0.05)。食欲下降组患者的透析前血清白蛋白35.10(33.15,37.80)g/L、血红蛋白(Hb)(93.48±17.00)g/L、前白蛋白281.90(223.45,323.70)mg/L、老年营养风险指数(GNRI)(90.45±6.41)分、主观全面评定法(SGA)评分5.00(4.00,5.00)分低于食欲较好组的36.80(34.20,39.60)g/L、(102.88±19.69)g/L、305.90(264.20,362.40)mg/L、(94.47±6.11)分、6.00(5.00,6.00)分,全血铜906.00(800.30,1049.00)μg/L、C反应蛋白(CRP)8.30(3.95,11.85)mg/L、白细胞介素-6(IL-6)13.34(8.27,19.56)pg/ml、白细胞计数7.13(5.74,8.36)×10^(9)/L、中性粒细胞计数4.97(3.82,5.99)×10^(9)/L高于食欲较好组的798.90(731.10,915.70)μg/L、3.20(1.10,8.20)mg/L、8.77(4.71,15.19)pg/ml、5.81(4.71,6.87)×10^(9)/L、3.85(3.13,4.74)×10^(9)/L,差异均具有统计学意义(P<0.05)。调整人口学和生化指标后,与食欲较好组相比,食欲下降组年龄≥65岁、CRP>3 mg/L患者占比较高,差异具有统计学意义(P<0.05)。使用多因素二元Logistic回归调整人口学和生化指标等混杂因素后,结果显示:较高的全血铜、女性和年龄≥65岁是MHD患者食欲下降的独立危险因素(P<0.05)。结论较高的全血铜水平可能在MHD患者食欲下降中起了重要作用。Objective To investigate the relationship between whole blood trace elements and appetite loss in maintenance hemodialysis(MHD)patients.Methods In 120 cases of MHD patients,the basic data,biochemical indexes and dialectation-related indexes were collected to determine the levels of manganese,zinc,copper,selenium and lead in whole blood before dialysis.According to simplified nutritional appetite questionnaire(SNAQ)score,patients were divided into good appetite group(SNAQ score≥14 points,99 cases)and decreased appetite group(SNAQ score<14 points,21 cases).The basic data,laboratory test results,and treatment regimens of the two groups were compared,and unifactorial and multifactorial binary Logistic regression models were used to analyze the influencing factors of the appetite of MHD patients.Results There were no significant differences in age,duration of dialysis,body mass index and primary disease between the two groups(P>0.05).The proportion of female patients in the decreased appetite group was 76.2%,which was higher than 38.4%in the good appetite group,and the difference was statistically significant(P<0.05).Before dialysis,the decreased appetite group had serum albumin of 35.10(33.15,37.80)g/L,hemoglobin(Hb)of(93.48±17.00)g/L,prealbumin of 281.90(223.45,323.70)mg/L,geriatric nutritional risk index(GNRI)of(90.45±6.41)points,subjective global assessment(SGA)score of 5.00(4.00,5.00)points,which were lower than 36.80(34.20,39.60)g/L,(102.88±19.69)g/L,305.90(264.20,362.40)mg/L,(94.47±6.11)points,6.00(5.00,6.00)points in the good appetite group;the decreased appetite group had whole blood copper of 906.00(800.30,1049.00)μg/L,C-reactive protein(CRP)of 8.30(3.95,11.85)mg/L,interleukin-6(IL-6)of 13.34(8.27,19.56)pg/ml,and white blood cell count of 7.13(5.74,8.36)×10^(9)/L,neutrophil count of 4.97(3.82,5.99)×10^(9)/L,which were higher than 798.90(731.10,915.70)μg/L,3.20(1.10,8.20)mg/L,8.77(4.71,15.19)pg/ml,5.81(4.71,6.87)×10^(9)/L,3.85(3.13,4.74)×10^(9)/L in the good appetite group;the difference was stati

关 键 词：维持性血液透析 全血铜 食欲 

分 类 号：R692.5[医药卫生—泌尿科学]