不同营养评估法对维持性血液透析患者生存状况的评估价值.pdfVIP

论著 ON THE 不同营养评估法对维持性 血液透析患者生存状况的评估价值 胡显芳 (重庆市涪陵区人民医院 408000) 【摘 要】目的 探究不同营养评估法对维持性血液透析患者 (MHD)营养状况的评价并了解其与MHD患者生存率之间的关 系。方法 收集84例MHD患者，测量包括身高、体重、体重指数 (BMI)、肱三头肌皮褶厚度 (TSF)、上臂围(MAC)、体重指数 (BMI)、血清总蛋白 (TP)、血清白蛋白 (ALB)、前白蛋白 (PA)、谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、血清尿素 氮 (BUN)、肌酐 (CREA)、血红蛋白 (Hb)及总铁结合 力 (TIBC)等指标，将上述资料在不同评估法分组的MHD患者 间进行比 较。此外，对所有患者进行随访，运用kaplan—meier生存函数 了解不同分组患者生存率间的差异性。结果 MIs及Ms分组后患者 在体重、BMI指数、TSF、TP、ALB、PA及TIBC等指标具有明显差异有统计学意义 (P0．05)。而MNA—SF组这种在上述指标间差 异无明显统计学意义 (P0．05)。MIs组重度营养不良者的生存率较轻、中度患者明显降低 (P0．05)，差异有统计学意义。 而轻、中度患者之间生存率差异无统计学意义 (P0．05)。经MNA-SF法划分后的轻、重营养不良患者间的生存率差异无统计学 意义 (P0．05)，而经Ms组划分后的轻、重两组患者生存率差异明显，具有统计学意义 (P=0．001)。结论 Ms评估法不仅能对 MHD患者早期营养状况作出判断，同时对患者的远期生存的评价也有重要价值。 【关键词】 营养评估法 维持性血液透析 生存率 Abstract Objective To detect the effects of different nutritional assessments on nutritional status of msintenance hemodialysis (MHD) patients and to eva1uate the refations between these assessments and the SUFViva1s．Methods 84 MHD patients’ informations inc1uding height，weight，BMI，TSF，MAC，ALT，AST，BUN，CREA，Hb and TIBC were collected．Compairing these datas with different groups by three assessments．Meanwhile，al1 pateines were followed to find out these surviva1．Finaly，to detect the difference of survival from different groups by three assessments．ResuIts The datas of weight，ALB，PA TSF，BMI and TIBC of mild malnutrition by MIS are lower than Severe malnutrition，as well as Ms(P0．os)．The differences by MNA-SF were not significant(P0．O5)．As the survival，in 60 months，the sever group by MIS is signifi cantly lower than those 0f miId and middle groups(P 0．05)．The difference between mild and middle was obvious as wel1 as mild and sever groups by MNA—SF．The SUFVival 0f mild group by Ms was significant higher than sever group(PO．05)．Conc I ut i on MS assessment not only could make a judgement of nutritional status of MHD patients in early period，but also can evaluated the Long—term surviva1 of MHD patients Key words： nutritJ onal assessment； maintenance hemodialysis；survi