维持性血液透析患者营养状况的评价

目的：评价维持性血液透析(MHD）患的营养状况。方法：对57例维持性血透患进行人体测量、生化指标的测定、饮食评估、主观综合营养评估(SGA)及综合性营养评估(GNA)。结果：不同指标评估营养不良的发生率分别为：三头肌皮皱厚度(TSF)66．7％，上臂中段肌肉周径(MAMC)33．3％，白蛋白(Alb)31．6％，前白蛋白(PA)45．6％，转铁蛋白(TRF)63．2％，饮食蛋白摄入(DPI)33．3％，SGA38．6％，GNA47．4％。各项指标均属正常仅占14，0％。依据GNA评分，营养不良组与营养良好组进行比较，Alb、PA、蛋白分解率(nPCR)、DPI、SGA评分均有统计学差异。结论：综合评价结果表明86．0％透析患存在不同程度的营养不良。GNA对血透患具有良好的营养评价作用。对MHD患进行常规的营养评价及合理的营养指导对预后有重要意义。

Assessment of Nutritional Status in Maintenance Hemodialysis Patients

Objective:To evaluate nutritional status of maintenance hemodialysis patients. Methods:Nutritional status indices including anthropometric measures, biochemical parameters, dietary assessments, subjective global assessments (SGA), and global nutrition assessments (GNA) were assessed in 57 hemodialysis patients. Results:The abnormal rates of these nutritional markers were: triceps skinfold thickness (TSF)66.7%, midarm muscle circumference (MAMC)33.3%, albumin(Alb)31.6%, prealbumin (PA)45.6%, transferrin(TRF)63.2%, dietary protein intake (DPI)33.3%, SGA 38.6% and GNA 47.4%, respectively. Patients with all these makers normal only accounted for 14%. Patients were classified into two nutritional groups according to GNA: normal nutrition and malnutrition. Serum Alb, PA, normalized protein catabolic rate (nPCR), DPI and SGA were significantly different between the two groups.Conclusion:86% of the dialysis patients were malnourished of various degrees. Global nutrition assessment is an effective way for evaluating the nutrition status in hemodialysis patients. Regular nutrition assessment and nutrition advice are very important for the better clinical outcome in hemodialysis patients.