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临床研究

维持性血液透析患者人体成分分析评估营养状况

  • 余毅 刘书凤 王琰 林曰勇 陈今 孙淑清
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  • 南京军区福州总医院血液净化科

收稿日期: 2015-09-07

  修回日期: 2016-03-27

  网络出版日期: 2016-06-19

Body composition analyses for the evaluation of nutritional status in maintenance hemodialysis patients

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Received date: 2015-09-07

  Revised date: 2016-03-27

  Online published: 2016-06-19

摘要

目的分析维持性血液透析(maintenance hemodialysis,MHD)患者人体成分,评估营养状况。方法选择MHD 患者57 例,应用人体成分分析仪(Body composition monitor,BCM)测量人体成分,检测患者透析前血清总胆固醇、三酰甘油、白蛋白、血红蛋白、血肌酐等生化指标,以体质量指数(body mass index,BMI)、单位体表面积脂肪含量、瘦组织含量的均值分组进行比较及相关分析。结果BMI 高组(BMI≥21.68kg/m2)与BMI 低组(BMI<21.68 kg/m2)比较,前者单位面积脂肪组织含量较高(t=4.327,P<0.001),BMI 与单位面积脂肪含量呈正相关(r=0.588,P<0.001)。2 组单位面积瘦组织含量差异无统计学意义(t=0.892,P=0.376),BMI 与单位面积瘦组织含量不存在直线相关(r=-0.109,P=0.419)。单位面积脂肪含量高组(≥12.29 kg/m2)与单位面积脂肪含量低组(<12.29 kg/m2)比较,前者胆固醇(t=2.882,P=0.006)、三酰甘油(t=2.040,P=0.047)、血红蛋白(t=3.857,P<0.001)均高于后者;单位面积脂肪含量与胆固醇(r=0.370,P=0.010)、三酰甘油(r=0.403,P=0.005)、血红蛋白(r=0.405,P=0.002)呈正相关。单位面积瘦组织含量高组(≥22.80 kg/m2)与单位面积瘦组织含量低组(<22.80 kg/m2)比较,前者血肌酐(t=2.515,P=0.015)、血清白蛋白(t=2.189,P=0.033)均高于后者;单位面积瘦组织含量与血肌酐(r=0.416,P=0.001)、白蛋白(r=0.315,P=0.018)呈正相关。结论BCM 能简便、准确、无创地评估MHD患者人体成分,有效评估营养状况。

本文引用格式

余毅 刘书凤 王琰 林曰勇 陈今 孙淑清 . 维持性血液透析患者人体成分分析评估营养状况[J]. 中国血液净化, 2016 , 15(06) : 353 -356 . DOI: 10.3969/j.issn.1671-4091.2016.06.010

Abstract

Objective To assess the nutritional status by body composition monitor (BCM) in maintenance hemodialysis (MHD) patients. Method A total of 57 MHD patients were enrolled in this study. Their body composition and laboratory data were measured and collected. Patients were divided into 2 groups according to the mean value of BMI. Fat and muscle content per body surface unit and laboratory data were then compared between the 2 groups. Result Fat content per body surface unit was higher in the high BMI group (BMI ≥21.68 kg/m2) than in the BMI low group (BMI <21.68 kg/m2) (t=4.327, P<0.001); univariate regression analysis found that BMI value was positively correlated with fat content per body surface unit (r=0.588, P<0.001). The difference in muscle content per body surface unit between high BMI group and low BMI group was statistical insignificant (t=0.892, P=0.376), and BMI value had no linear correlation with muscle content per body surface unit (r=-0.109, P=0.419). Cholesterol (t=2.882, P=0.006), triglyceride (t=2.040, P= 0.047) and hemoglobin (t=3.857, P<0.001) were higher in the high fat content per body surface unit (≥12.29 kg/m2) group than in the low fat content per body surface unit (<12.29 kg/m2); fat content per body surface unit was positively correlated with cholesterol (r=0.370, P=0.010), triglyceride (t=0.403, P=0.005) and hemoglobin (r=0.405, P=0.002) levels. Serum creatinine (t=2.515, P=0.015) and albumin (t=2.189, P=0.033) were higher in the high muscle content per body surface unit group (≥22.80 kg/m2) than in the low muscle content per body surface unit group (<22.80 kg/m2); muscle content per body surface unit was positively correlated with serum creatinine (r=0.416, P=0.001) and albumin (r=0.315, P=0.018). Conclusion The nutritional status in MHD patients could be conveniently and accurately assessed by BCM.
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