生物电阻抗法评估维持性血液透析患者人体成分的纵向变化  

Longitudinal Changes in Body Composition of Patients Undergoing Maintenance Hemodialysis Assessed by BIA

作　　者：许明 高源华 矫春晓 曲少琴 孙晓燕 李海强 XU Ming;GAO Yuan-hua;JIAO Chun-xiao;QU Shao-qin;SUN Xiao-yan;LI Hai-qiang(Department of Nutrition,Yantai Yeda Hospital,Yantai Shandong 264006,China;Department of Blood Purifi cation,Yantai Yeda Hospital,Yantai Shandong 264006,China)

机构地区：[1]烟台业达医院营养科,山东烟台264006 [2]烟台业达医院血液净化科,山东烟台264006

出　　处：《中华养生保健》2025年第7期76-79,共4页CHINESE HEALTH CARE

摘　　要：目的利用生物电阻抗法评估维持性血液透析患者1年前后人体成分的纵向变化。方法选取2020年1月1日—2023年2月28日在烟台业达医院行规律血液透析的120例患者资料,其中男性61例,女性59例;年龄29~84岁,平均年龄(56.23±13.52)岁;≥60岁老年患者50例;患者间隔1年时间完成2次人体成分分析,收集人体成分分析数据以及对应月份的白蛋白、前白蛋白、肌酐、尿素等生化指标结果。采用自身前后对照的方法,比较1年前后患者各项生化指标及人体成分指标的差异;并对人体成分同白蛋白的相关性进行分析。结果与1年前比较,1年后120例血液透析患者前白蛋白降低,铁蛋白、血红蛋白、肌酐均升高,差异有统计学意义(P<0.05)。与1年前比较,1年后120例血液透析患者人体成分分析结果中身体细胞量、蛋白质、骨骼肌含量、去脂体质量、相位角等指标均显著下降,内脏脂肪面积增加,差异均有统计学意义(P<0.05)。按性别分层分析后发现不同性别人群人体成分变化也具有较大差异;相关性分析显示,白蛋白同身体细胞量、蛋白质、骨骼肌量、相位角均呈正相关(P<0.05)。结论相较于生化指标,身体细胞量、蛋白质、骨骼肌含量、相位角等人体成分指标在维持性血液透析患者的纵向观察中变化更为显著,应重视其在血液透析患者长期营养管理中的作用。Objective To investigate the longitudinal changes in body composition of patients undergoing maintenance hemodialysis by BIA.Methods Data was collected from patients underwent regular hemodialysis in the hemodialysis center of Yantai Yeda Hospital from January 1,2020 to February 28,2023.Data collected from a total number of 120 patients,61 males and 59 females,aged 29-84(56.23±13.52),and 50 patients aged over 60.Participants were selected from patients who completed two body composition analysis,and each analysis was completed at least one year apart.Body composition analysis and biochemical indicators such as albumin,prealbumin,creatinine,urea were collected in the month of completing the body composition analysis.Compared the results of laboratory biomarkers and body composition from two tests.Results Compared with one year before,significant differences were discovered that the level of prealbumin(P<0.05)decreased,while ferritin,hemoglobin and creatinine(P<0.05)increased.Body composition analysis showed that indicators like Body Cell Mass,protein,Skeletal Muscle Mass,Fat Free Mass,mineral and Phase Angle were signifi cantly decreased(P<0.05),while Visceral Vat Area increased(P<0.05).After stratifi ed analysis by sex,signifi cant diff erences of human body composition between diff erent genders were found;Albumin was signifi cantly positively correlated with Body Cell Mass,protein,Skeletal Muscle Mass and Phase Angle in two groups(P<0.05).Conclusion Compared to biochemical indicators,changes in body composition parameters such as body cell mass,protein,skeletal muscle mass,and phase angle are more signifi cant in the longitudinal observation of patients undergoing maintenance hemodialysis.The importance of these parameters in the long-term nutritional management of hemodialysis patients should be emphasized.

关 键 词：肾透析 营养管理 生物电阻抗 

分 类 号：R692.5[医药卫生—泌尿科学]