影响维持性血透患者生存质量的营养因素分析

目的 分析影响维持性血透患者生存质量的营养因素.方法 采用横断面调查研究方法,选取上海中医药大学附属岳阳中西医结合医院2018年1月—2020年12月维持性血液透析患者201例,男106例,女95例,平均年龄(62. 5±11. 8)岁,平均透析龄(25. 4±12. 3)个月.测量干体质量、身高、体质量指数(body...

Effect of nutritional status on quality of life in patients with maintenance hemodialysis

Objective To analyze the impact of nutritional status on the quality of life in patients undergoing maintenance hemodialysis. Methods A total of 201 patients, 106 males and 95 females with an average age of(62.5±11.8) years, who underwent maintenance hemodialysis with an average dialysis duration of(25.4±12.3) months, in Yueyang Integrated Traditional Chinese and Western Medicine Hospital from January 2018 to December 2020, were enrolled in the study. The dry weight, height, body mass index(BMI), grip strength(HS), triceps skinfold thickness(TSF) and the upper arm muscle circumference(AMC), the biochemical and blood routine indexes were measured. The nutritional evaluation was carried out with the improved quantitative subjective global assessment(MQSGA) and the quality of life was evaluated with SF-36 scale. Results The analysis showed that age, gender, dialysis duration and nutritional status were significantly associated with the quality of life of hemodialysis patients. The quality of life of elderly patients was lower than that of non-elderly patients(P<0.05). Male patients had better quality of life than female patients(P<0.05). The quality of life improved with the increase of hemodialysis duration, but it declined after three years of hemodialysis. The QOL of patients was negatively correlated with MQSGA scores and positively correlated with blood albumin level(P<0.05). For each domain of SF-36 scale, the physical functioning(PF) of patients was negatively correlated with the MQSGA scores and positively correlated with albumin, grip strength, and AMC; the role-physical(RP) was negatively correlated with MQSGA scores and positively correlated with albumin; the bodily pain(BP) was positively correlated with grip strength; the general health status(GH) was negatively correlated with MQSGA scores and positively correlated with grip strength and AMC; the mental health(MH) was positively correlated with AMC; the role-emontional(RE) was positively correlated with albumin; the social functioning(SF) was negatively correlated with MQSGA scores; the viability(VT) was negatively correlated with MQSGA scores and positively correlated with albumin, hemoglobin and AMC(all P<0.05). Conclusion Nutritional status is an independent risk factor for the quality of life in patients with maintenance hemodialysis, particularly, the reserve of visceral protein and muscle protein have a great impact on the quality of life.