血液透析患者营养状态评估的临床研究

【目的】探讨综合性营养评估法（GNA）对血液透析患者营养状况的评价作用。【方法】建立了由13项主、客观评价指标组成的GNA，对57例维持性血透患者进行营养评估，分析GNA与各项营养指标的相关性。【结果】本组营养不良发生率为54．4％（31／57）。GNA评分与血清白蛋白（A1b）、前白蛋白（PA）、肌酐（SCr）、蛋白分解率（nPCR）、饮食蛋白摄入（DPI）、SGA评分、近期体重变化、消化道症状、肌肉消耗程度、水肿、皮下脂肪厚度均具有显著相关性（P〈0．01），与胆固醇（Ch）、尿素氮（BUN）、转铁蛋白（TRF）明显相关（P〈0．05）。多重回归分析显示，GNA评分与PA、SCr、nPCR、SGA、TRF、A1b、Ch均显著相关。【结论】GNA对血透患者具有良好的营养评价作用，半数以上的血透患者发生营养不良。

Clinical Study on Global Nutrition Assessment in Hemodialysis Patients

Objective] To study the value of global nutrition assessment（GNA） for evaluating nutritional status in maintenance hemodialysis patients. Methods] A ＂global nutrition assessment＂ including 13 variables derived from subjective global assessment （SGA）, anthropometrics and biochemistry was made. Fifty＇seven patients with maintenance hcmodialysis were selected in this study. The relationship between GNA and the other nutritional parameters was analyzed by using Pearson analysis and multiple linear regression analysis. Results]Thirty-one patients （54.4%） were malnourished. The GNA score showed a significant correlation with serum albumin （A1b）, prealbumin （PA）, creatinine （SCr）, normalized protein catabolic rate （nPCR）, dietary protein intake （DPI）, SGA score, weight change, gastrointestinal symptoms, edema （P〈0. 001）, muscle wasting, loss of subcutaneous fat （P〈0. 01）, cholesterol （Ch）, blood urea nitrogen （BUN） and transferrin （TRF） （P〈0.05）. Multiple linear regression analysis showed a significant correlation between theGNA score and the combination of the PA, SCr, nPCR, SGA, TRF, Alb and Ch （R=0.971, P〈0. 001）. Conclusion]Global nutrition assessment is an effeetive way for evaluating the nutrition status in he-modialvsis patients. And ahnve half of the patients are malnourished.