维持血透病人的营养状况分析

目的 :了解血透患者的营养状态并找出引起其营养不良的相关因素。方法 :采用SGA法对 10 6例血透患者进行营养学评价 ,用人体学测量及生化检查作为营养学指标进行各相关因素分析。结果 :10 6例血透患者中 6 0 1%存在不同程度的营养不良 ,普遍存在能量、蛋白质摄入不足、饮食结构不合理 ,与健康人比较各营养学指标均偏低(P <0 .0 5 ) ,摄入充分组、透析充分组及酸中毒较轻组各营养学指标均较对照组有显著性差异 (P <0 .0 1)。用促红细胞生成素组成部分营养指标要好于未用者 (P <0 .0 5 )。透析膜的生物相容性、年龄、维持透析时间、残余肾功能的情况均对营养状态有影响。结论 :透析患者的营养状态应引起足够重视 ,增加摄入 ,充分透析 ,促红素等药物的应用 ,酸中毒的纠正 ,生物相容性透析膜的使用及残余肾功能的保护是改善透析患者营养状态的途径     

应用主观全面评定法评价维持性血液透析患者营养状况

目的应用主观全面评定法（SGA）对维持性血液透析患者（MHD）的营养状态进行评价。方法对116例MHD患者应用SGA方法进行营养评估，测定肱三头肌皮褶厚度、上臂围、上臂肌围（MAMC）等人体测量学指标和血清白蛋白（ALB）、C反应蛋白（CRP）等实验室指标，并进行相关性分析。结果SGA法的评定结果与年龄、透析时间、肱三头肌皮褶厚度、上臂围、MAMC、体质指数（BMI）、ALB、CRP均有显著相关性（P〈0．01）；与总蛋白、血清肌酐无相关性（P〉0．05）。多因素分析显示，在调节年龄、BMI后，SGA评分与CRP、ALB、MAMC仍存在显著相关性（相关系数分别为0．2816、0．3368、0．6143，P〈0．05）。结论SGA法在我国MHD患者的营养评价中适用，是一种经济、有效的营养评定方法。     

Poor Sleep Quality Is Associated with Altered Taste Perception in Chinese Adults

BackgroundSmall clinical studies have suggested that individuals with insufficient sleep could experience taste dysfunction. However, this notion has not been examined in a large-scale, population-based study.ObjectiveThis study aimed to examine whether overall sleep quality, as assessed by insomnia, daytime sleepiness, snoring, and sleep duration, was associated with the odds of having altered taste perception in a large population-based study.DesignThis was a cross-sectional study that used data from a subcohort of the Kailuan study, an ongoing multicenter cohort study that began in 2006 in Tangshan City, China.Participants/settingThe participants were 11,030 adults aged 25 years or older (mean age 53.7 ± 10.7 years), who were free of neurodegenerative diseases. All the participants had undergone questionnaire assessments and medical examinations at Kailuan General Hospital from June 2012 to October 2013.Main outcome measuresAltered taste and olfactory perception were assessed via a questionnaire with two questions regarding whether participants had any problems with sense of taste or smell for ≥3 months.Statistical analyses performedThe association between sleep quality and altered taste/olfactory perception was examined using a logistic regression model, adjusting for age, sex, lifestyle factors (eg, obesity, smoking, alcohol intake, and physical activity) and health status (eg, lipid profiles, blood pressure, modification use, and presence of chronic diseases).ResultsPoor overall sleep quality was associated with a higher risk of having altered taste perception (adjusted odds ratio for low vs high sleep quality 2.03, 95% CI 1.42 to 2.91; P < 0.001). Specifically, insomnia, daytime sleepiness, and short sleep duration, but not prolonged sleep duration and snoring, were significantly associated with altered taste perception. A significant association between overall sleep quality and the risk of having altered olfactory perception was also observed (adjusted odds ratio for low vs high sleep quality 2.17, 95% CI 1.68 to 2.80; P < 0.001).ConclusionsIn this population-based study, poor sleep quality was associated with a high likelihood of altered taste perception.     

高通量血液透析联合左卡尼汀治疗对维持性血液透析患者生活质量和营养状况的影响

目的探讨高通量血液透析联合左卡尼汀治疗对维持性血液透析患者生活质量和营养状况的影响。方法 60例终末期肾脏病患者随机分为两组各30例,对照组给予低通量血液透析联合左卡尼汀治疗,治疗组给予高通量血液透析联合左卡尼汀治疗,比较两组治疗后的生活质量和营养状况。结果治疗后,治疗组患者的情感职能、社会功能、精神健康、生理功能、躯体疼痛等生活质量评分均显著高于对照组, MQSGA评分显著低于对照组, Hb、 RBC计数显著高于对照组,差异均有统计学意义(P <0.05)。结论高通量血液透析联合左卡尼汀治疗维持性血液透析患者,能够显著提高患者的生活质量,改善营养状况。     

血液透析联合腹膜透析对尿毒症患者心功能及营养状态的影响

目的 探讨血液透析联合腹膜透析对尿毒症患者心功能及营养状态的影响.方法 98例尿毒症患者随机分为两组各49例,对照组采用腹膜透析治疗,观察组采用血液透析联合腹膜透析治疗,比较两组治疗前后的心功能、营养状态以及并发症.结果 治疗后,两组的LVEF、Hb含量、A1b含量均较治疗前显著升高,且观察组的各项指标均显著高于对照组...     

生物电阻抗分析法(BIA)在评估维持性血液透析患者营养状况中的应用

<正>维持性血液透析(MHD)患者中存在蛋白质-能量营养不良达23%~73%[1]。营养不良患者的人体代谢会发生变化,其人体成分也会发生相应的改变,所以人体成分成可作为营养评价及营养支持的一个重要监测指标[2]。人体成分是人体内各种成分之间的数量比例,可以反映人体的营养状况、体液平衡状况、提供人体成分正常值范围、评价生长发育等,在临床医学与基础研究中具有重要的价值[3]。本研究应用BIA对MHD患者的人体成