糖尿病炎症对维持性透析患者营养状况的影响.docVIP

糖尿病、炎症对维持性透析患者营养状况的影响 【摘要】 目的 通过分析影响维持性透析患者营养状况的因素，以期进一步提高患者生活质量。 方法 调查2003年9月1日～2004年3月31日在本科进行透析的终末期肾病患者的临床资料，包括性别、年龄、透析龄和糖尿病发病情况;采用主观综合评估（subjective global assessment，SGA）来评价患者的营养状况，采用Karnofsky指数评估患者活动能力，采用ICED（index of co-existence disease）系统来评估患者合并症情况，自动生化检测仪检测患者血清白蛋白、胆固醇、三酰甘油、低密度脂蛋白。 结果 有45例入选本研究，糖尿病患者占42.22%（19/45）。轻-中度营养不良发生率为44.44%（20/45），严重营养不良发生率为2.22%（1/45），血清CRP与血清白蛋白呈负相关（r=-0.44，P0.01）;在糖尿病组，尽管患者年龄、血液透析龄及每日残余尿量与非糖尿病组无差异，但营养不良发生率和血清CRP水平明显高于后者（68.4%vs30.8%，P0.05;17.32±19.70，5.53±14.38，P0.05），而血清白蛋白水平则明显低于后者（31.96±4.99vs35.69±4.39，P0.05）。 结论 糖尿病、炎症是影响维持性透析患者营养状况的重要因素。 　　关键词 维持性血液透析 糖尿病 炎症 营养不良 　　Effect of diabetes mellitus，inflammation on nutritional status in patients with maintenance hemodialysis 　　Zheng Jing 　　Department of Internal Medicine，The First Peoples Hospital of Jiujiang，Jiangxi332000. 　　【Abstract】 Objective To analyze the contribution to malnutrition in patients with maintenance dialysis.Methods Between1st Sep.2003and31st Mar.2003，all patients with maintenance dialysis were recruited.Patient demographic characteristics，duration of dialysis，the primary disease，the prevalence of malnutrition（assessed by SGA）were recorded.Complication was assessed by ICED（index of co-existence disease），and physical function was evalu-ated by Karnofsky index.Moreover，blood samples were collected for measuring serum albumin，C-reactive protein（CRP）and lipid.Results A total of45patients were included in the current study，of which，diabetes mellitus was in19（42.22%）cases.In the entire subjects，the prevalence rate in mild-moderate malnutrition was44.44%（20/45），in severe malnutrition2.22%.A significantly negative correlation was showed between serum C-reactive protein and serum albumin.Moreover，there were higher prevalence of malnutrition and level of serum CRP in patients with diabetes mellitus than in patients with non-diabetes mellitus（68.4%vs30.8%，P0.05;17.32±19.70，5.53±14.38P0.05），but decreased l