应用主观全面评定法评价维持性血液透析患者营养状况

目的应用主观全面评定法（SGA）对维持性血液透析患者（MHD）的营养状态进行评价。方法对116例MHD患者应用SGA方法进行营养评估，测定肱三头肌皮褶厚度、上臂围、上臂肌围（MAMC）等人体测量学指标和血清白蛋白（ALB）、C反应蛋白（CRP）等实验室指标，并进行相关性分析。结果SGA法的评定结果与年龄、透析时间、肱三头肌皮褶厚度、上臂围、MAMC、体质指数（BMI）、ALB、CRP均有显著相关性（P〈0．01）；与总蛋白、血清肌酐无相关性（P〉0．05）。多因素分析显示，在调节年龄、BMI后，SGA评分与CRP、ALB、MAMC仍存在显著相关性（相关系数分别为0．2816、0．3368、0．6143，P〈0．05）。结论SGA法在我国MHD患者的营养评价中适用，是一种经济、有效的营养评定方法。

Application of Subjective Global Assessment for Assessing Nutritional Status in Patients with Maintenance Hemodialysis

Objective To evaluate the value of the subjective global assessment （SGA） for the nutritional status in patients with maintenance hemodialysis （MHD）. Methods Totally 116 patients with MHD were enrolled in this study. The SGA were used to assess the nutritional status in these patients. Meanwhile, the anthropometrie measurements including mid-upper arm circumference （MAC）, triceps skin-fold thinkness （TSF）, calculated mid-upper arm muscle circumference （MAMC） , body mass index （BMI） , and biochemical parameters including serum albumin and C reactive protein （CRP） were measured. Results Malnutrition score assessed by the SGA was significantly correlated with age, length of MHD, TSF, MAC, MAMC, BMI, serum albumin, CRP （P 〈0. 01 ）; however, no such correlation was observed between SGA and the serum total protein/ereatinine （P 〉 0. 05）. Multile factors analysis showed that when age, BMI were adjusted, the malnutrition score was significantly correlated with CRP, albumin, and MAMC （ r = 0. 2816, r =0. 3368, and r = 0. 6143 ; P 〈 0. 05）. Conclusion SGA is efficient and cost-effective in evaluating the nutrition status of MHD patients, and would be a economic, efficiency tool in nutritional assessment.