维持性血液透析患者营养不良与动脉粥样硬化的关系

目的 探讨慢性肾功能衰竭维持性血液透析（MHD）患者营养不良与动脉粥样硬化的关系。方法 采用综合营养评估法（GNA）对108例MHD患者营养状态进行评价，根据不同GNA数值分为3组。A组：营养良好，GNA〈7．5分；B组：轻至中度营养不良，GNA7．5～15．0分；C组：重度营养不良，GNA〉15分。用高分辨率超声技术检测惠者颈动脉粥样斑块的发生率及多发率，颈动脉内膜．中层厚度，分析3组颈动脉病变情况。结果 GNA评估：A组58例（53．7％），B组32例（29．6％），C组18例（16．7％）。B组颈动脉病变明显，与A组比较差异有显著性（P〈0．01），同样C组病变更明显，与B组比较差异有显著性（P〈0．01）。结论 营养不良与动脉粥样硬化是维持性血液透析常见的并发症。两者关系密切，营养状态愈差。发生动脉粥样硬化的比率愈高。

Association of malnutrition and atherosclerosis in maintenance hemodialysis patients

Objective To study the relationship between malnutrition and atherosclerosis in maintenance hemodialysis(MHD) patients.Methods One hundred and eight MHD patients were divided into three groups according to the state of nutrition evaluated with general nutrition assessment(GNA): non-malnutrition group(group A,GNA<7.5);Mild to moderate-malnutrition group(group B,GNA=7.5-15.0);Severe-malnutrition group(group C,GNA>15).The carotid artery was checked in all patients to determine carotid intima-media thickness(CIMT) and the prevalence of atherosclerotic plagues by high-resolution ultrosonography.Results There were 58 cases in group A(53.7%),32 cases in group B(29.6%),and 18 cases in group C(16.7%).The mean CIMT value and prevalence of atherosclerotic plaques were significantly increased in mild to group B compared with those in group A(P<0.01),and the same result in group C compared with group B(P<0.01).Conclusion Malnutrition and atherosclerosis are common complications of MHD,and the relationship between them is rather close,as indicated above that degrees of atherosclerosis are associated with the state of nutrition in MHD.