血液透析患者3种整体营养状况评估方法的比较研究

目的比较研究血液透析患者3种整体营养评估方法(SGA、MQSGA、CMIS)与客观营养指标如(血生化、人体指数学)的相关性,为选择血液透析患者营养状态的临床评估方法的提供依据。方法使用主观整体评估(SGA)、改良定量主观整体评估(MQSGA)、营养不良炎症综合评估(CMIS)3种营养评估方法评估中山大学附属第一医院肾内科血液透析患者营养状况;同时测定患者人体指数学、白蛋白、IGF-1等客观营养指标;SPSS10.0统计处理其相关关系。结果SGA、MQSGA、CMIS3种整体营养不良的评估方法各有特点,与血生化和人体学指标呈现明显相关关系(P<0.05)。但是以MQSGA与常用客观营养指标的复合相关系数最大(r=0.985),相关性最为密切,其次CMIS和SGA。结论SGA、MQSGA、CMIS3种评估方法都具有较好的准确性和可靠性,但以MQSGA较优。MQSGA更为客观准确,而且简单、无创,故较适合评估透析患者的整体营养状态。

Comparison of the three methods for the evaluation of overall nutritional status in hemodialysis patients

Objectives To compare the three methods used for the evaluation of nutritional status in hemo- dialysis patients. Methods Subjective global assessment (SGA), modified quantitative subjective global assessment (MQSGA), and comprehensive malnutrition-inflammation survey (CMIS) were used to evaluate the nutritional sta- tus of the patients. Serum albumin, serum insulin-like growth factor-1 (IGF-1) and anthropometry were measured. Results The results of evaluation by SGA, MQSGA, CMIS were closely related to those by serum biochemistry and anthropometry (P < 0.05), but the three methods had their respective advantages in the evaluation of overall nutrition. The composite correlation coefficient between the method for nutritional assessment and the objective nutritional index commonly used was higher in MQSGA (r = 0.985) than in SGA or CMIS. Conclusions SGA, MQSGA and CMIS can be used to evaluate nutritional status, and MQSGA is the best one among the three methods in the assess- ment of overall nutritional status for hemodialysis patients.