透析患者血浆游离IGF-I浓度与患者营养状态的评估

目的 研究透析患血浆游离胰岛素样生长因子I（IGF-I）浓度与患营养状态的关系。并探讨秀析患在透析过程中是否有游离IGF-I的丢失。方法 对14例进行持续性不卧床腹膜透析（CAPD）和17例进行维持性血透（HD）患以及15例对照进行有关主观综合营养评估（SGA）及生化检查营养评估。同时检测患血浆中和部分患腹膜透出液的游离IGF-I浓度，并分析它们是否相关。结果 用SGA方法，腹透患的营养不良发生率为64.1%。血透患的发生率为58.9%。若采用生化检查评估，前为28.5%。后为29.4%。无论前或后，血浆中游离IGF-I浓度均明显低于对照组，此外还发现腹膜透析液中的游离IGF-I含量几乎与患血浆含量相同。结论 若采用主观综合评估透析，患的营养不良发生率是相当高的，透析患血浆中游离IGF-I浓度明显低于对照组，其血浆浓度的高低可作为患营养不良的敏感指标。腹秀患在透析中丢失游离IGF-I亦可能是造成此类患血中游离IGF-I低下的原因之一。

Free Insulin-like Growth Factor I Plasma Level and Assessment of Nutritional Status in Dialysis Patients

Objective To investigate the relationship between free insulin-like growth f actor I(IGF-I)plasma level and nutritional status in dialysis patients,and r esearch whether free IGF-I was lost into draining dialysate during dialyze.Meth ods 17patents were treated with CAPD,14cases with HD and15controls were n utritional assessed by subjective global assessment (SGA)and biochemistry assa y respectively.All patients were examined the free IGF-I palsma level,and10 cases with CAPD were measured the free IGF-I level in the peritoneal dialysate. Then the corretation analysis of them was made.Results It has been found that m alnutrition rate was64.1%and28.5%in CAPD,58.9%and29.4%in HD by SGA and biochemistry assay respectively.The free IGF-I level of the patient s with CAPD or HD was significantly lower than that of the controls.There was a close relationship between free IGF-I plasma level and nutrition condition of patients with dialysis.It was showed that the level of free IGF-I in peritoneal dialysate was close to that of the plasma.Conclusions The malnutrition rate i n dialysis patients is rather high by SGA.The free IGF-I level of patients with dialysis were significantly lower than the controls.The present study was sug gested that the free IGF-I plasma level is a sensitive marker for nutritional c ondition,and the loss of the free IGF-I into draining dialysate during dialyze might be one of the factors which making the plasma level of free IGF-I lower.