270例老年慢性肾脏病患者膳食结构及营养状况分析

  目的  了解老年慢性肾脏病(chronic kidney disease，CKD)患者的膳食结构和营养状况，为指导老年慢性肾脏病患者合理膳食提供依据。  方法  以2020年7—12月在温州医科大学附属第二医院住院接受治疗的270例CKD患者为研究对象，采用一般资料调查表、营养风险筛查表、食物频率问卷对CKD患者的膳食结构及营养状况进行调查，比较营养不良风险者和营养良好者的人体测量、生化检查结果及膳食结构。  结果  270例老年肾脏病患者存在营养不良风险者65例，占24.07%；营养良好者205例，占75.93%。营养不良风险者CKD分期2期的构成、体质指数正常的构成、上臂围、肱三头肌皮褶厚度、血清白蛋白、前白蛋白均低于营养良好者，差异有统计学意义(χ2=6.943、9.360；t=4.313、2.742、3.458、3.204，均P＜0.05)。营养不良风险者膳食中谷薯、水果、蔬菜、鱼虾类食物摄入不足构成均高于营养良好者，差异有统计学意义(Z=3.912、5.750、4.055、4.474，均P＜0.01)。  结论  老年慢性肾脏病患者的营养不良风险率较高，临床上应加强老年慢性肾脏病患者的膳食指导和健康教育，改善患者的营养状况。 

Dietary structure and nutritional status of 270 elderly patients with chronic kidney disease

  Objective  To understand the dietary structure and nutritional status of elderly patients with chronic kidney disease and provide a basis for guiding the rational diet of elderly patients with chronic kidney disease.  Methods  A total of 270 patients with CKD, who were hospitalised in our hospital from July to December 2020, were selected as study subjects, and the general data questionnaire, nutritional risk screening 2002 and semi-quantitative food frequency questionnaire were used for investigation. Anthropometric and biochemical results and dietary structure of patients at risk of malnutrition and those of patients with good nutrition were compared.  Results  A total of 65 (24.07%) were at risk of malnutrition, 205 cases had good nutrition, accounting for 75.93%. The CKD Ⅱ stage BMI, AC, TSF, ALB and PA of the patients at risk of malnutrition were lower than those of patients with good nutrition, and the differences were statistically significant (χ2=6.943, 9.360; t=4.313, 2.742, 3.458, 3.204, all P < 0.05). The proportion of insufficient intake of potatoes, fruits, vegetables, fish and shrimp in the diet of patients at risk of malnutrition were higher than those of patients with good nutrition, and the differences were statistically significant (Z=3.912, 5.750, 4.055, 4.474, all P < 0.01).  Conclusion  Elderly patients with chronic kidney disease are at high risk of malnutrition. In clinical practice, dietary guidance and health education should be strengthened for elderly patients with chronic kidney disease to improve the nutritional status of patients.