BIA法评估44例CKD患者的营养状况及分析

摘要:目的　运用生物电阻抗分析（Bioelectric Impedance Analysis，BIA）评价慢性肾脏病（Chronic Kidney Disease，CKD）患者的营养状况，并将其和生化指标评估结果对比，为早期发现CKD患者营养不良状态、及时给予营养干预提供有效参考。方法　随机选择2014年11月-12月期间在某三甲医院CKD管理中心注册的CKD患者57例，根据其浮肿指数、依从性等共纳入研究对象44例，应用BIA法评估研究对象的营养状况并与生化指标评价结果比较。结果　BIA和生化检查营养不良率（含营养不良风险）分别为45.4%和25%，且差异有统计学意义（χ2＝4.034，P＜0.05）。女性身体细胞量、细胞内水分和蛋白质的质量均显著高于男性（P＜0.05），而男、女性ALB水平差异无统计学意义。在ALB水平正常的CKD患者中，其体细胞量、细胞内水分、蛋白质、骨骼肌、体脂肪均低于正常范围。BIA营养不良的研究对象的骨骼肌量和血清白蛋白（serum Albumin，ALB）水平显著相关（r＝0.58，P＜0.05）。结论　CKD患者营养不良率较高；与生化检查相比，BIA可早期发现CKD患者的营养不良状态和营养不良风险，有利于医生对营养不良患者及时采取有效的营养干预。

Evaluation and analysis of bioelectrical impedance analysis in 44 patients with chronic kidney disease

Abstract: Objective To analyze the reliability of bioelectric impedance analysis (BIA) in malnutrition diagnosis by comparing it with serum albumin in a group of 44 chronic kidney disease (CKD) patients. For early detection of malnutrition of CKD patients and provide certain reference for seasonable clinical nutrition support. Methods We randomly selected 57 cases from CKD management centers in a 3A hospital from November to December in 2014. We conducted 44 patients who met the standards according to swelling index, compliance and so on. We used BIA to assess the nutritional status and compared the result with that of biochemical examination. Results Prevalences of malnutrition determinate by BIA and ALB were 45.4% and 25%, with a significantly statistical difference (P<0.05). Intracellular body water (ICW), protein and body cell mass (BCM) of female were higher than those of male with significantly statistical differences (P<0.05). The level of ALB between male and female had no significantly statistical differences (P>0.05). BCM, protein, ICW, skeletal muscle mass (SMM) and body fat mass（BFM）were below the normal level in patients with normal ALB level. SMM and ALB of malnutrition patients had a significant correlation (P<0.05). Conclusion A high proportion of CKD patient present malnutrition. BIA can detect early stage malnutrition status. It was conducive to doctors to adopt effective interventions to conduct nourishment support.