社区高龄男性慢性肾脏病患者的营养和心理健康状况调查

目的了解北京某社区高龄老年男性人群慢性肾脏病（CKD）的患病情况,并评估其营养和心理健康状况.方法采取整群分层抽样的方法,选取北京市丰台区6个社区的≥80岁男性老年人进行横断面调查,筛查出CKD患者,采用微型营养评定精法（MNA-SF）评估其营养状况,并采用霍普金斯症状调查表（HSCL-10）评估患者的心理健康状况,分析营养、心理与CKD之间的关系.结果①在接受调查的436例高龄男性中,筛查出CKD患者164例（37.6％）.1期占16.5％（27例）,2期占25.0％（41例）,3期占45.1％（3a期50例,占30.5％,3b期24例,占14.6％）,4期占8.5％（14例）,5期占4.9％（8例）.②在高龄CKD患者中,营养不良者占9.1％（15例）,存在营养不良风险者占25.0％（41例）,营养良好者占65.9％（108例）;CKD1～5期患者伴有营养不良及营养不良风险的发生率分别为14.8％（4例）、26.8％（1 1例）、32.0％（16例）、33.3％（8例）、9/14、8/8,MNA-SF营养评分随CKD的进展呈逐渐下降趋势（r=0.458,P＜0.01）.③CKD患者的HSCL-10评分随CKD的进展呈逐步升高趋势（r=-0.337,P＜0.01）.结论高龄老年男性CKD的患病率较高,以CKD 3期尤其是3a期多见.随着CKD的进展,高龄患者的营养状况逐渐下降,焦虑、抑郁等心理疾病也逐渐加重.

A survey of nutritional and mental health condition in elderly community-dwelling males with chronic kidney disease

Objective To explore the prevalence of chronic kidney disease （CKD） and evaluate their nulrilional aml mental heahh status in elderly conmmnity-dwelling males. Methods A stratified cluster random sampling method wax used. A total of 436 senile males （ ≥ 80 yeats old） were recruited front 6 communities of Fengtai District, Beijing. After screening those with CKD, the risks of malnutrition were assessed by the mini mltritional assessment-short form （MNA-SF） plus anthropometrie measurements and bio-ehemieal markers. And the mental health eondition was measured by the Hopkins symptoms eheek list-lO （ttSCL-10）. Results （1） The prevalence of CKD in senile males of this study was 37.6% （ n = 164） ; （2） According to the MNA-SF score, 9. 1% （n = 15） were nmlnourished and 25.0% （n = 41 ） at the risk of umhmlriliou. From CKD stage 1 to stage 5, the prevalence of malnutrition and at the risk of mahmtritiou were 14.8Ck（n=4）,26.8%（n=11）,32.0%（n=16）,33.3%（n=8）,9/14, 8/8 respectively; （3）The level of HSCI,-IO score rose with the progression of CKD in senile males. Conclusion There is a high prevalence of CKD in ehlerly community-dwelling males. With the progression of CKD, their nutritional conditions and depression and anxiety symptoms worsen.