持续非卧床腹膜透析患者营养状况评价

Evaluation of nutritional status in continuous ambulatory peritoneal dialysis patients

关键词:  腹膜透析患者  营养评价  营养不良

Key words:  peritoneal dialysis population  nutrition assessment  malnutrition  

摘要:

目的探讨持续非卧床腹膜透析（continuous ambulatory peritoneal dialysis, CAPD）患者的营养状况。方法随机选择病情稳定，符合观察奈件的透析患者52例（男／女，32／20）。进行膳食营养评价、半定量SGA评分、人体测量以及生化指标检测。结果CAPD患者营养不良发生率高：以SGA评分作为评价指标，78．8％的患者有不同程度的营养不良：vJ,ALB作为评价指标，67．3％的患者营养不良；基于AMC判断，则有55．8％的患者营养不良。营养摄入量与营养评价指标关系密切：DEI与BMI呈正相关（P〈0．05），与ALB、PA呈正相关（P〈0．05，P〈0．01），而与SGA、CRP呈负相关（P〈0．01，P〈0．05）：DPI与PA呈正相关（P〈0．01）。蛋白质摄入充分组PA明显高于摄／k不足组（P〈0．01）；热量摄入充分组ALB高于摄入不足组（P〈0．05）。结论CAPD患者营养不良发生率高，膳食营养与CAPD患者营养状况密切相关．就维持血浆蛋白而言，摄入充足的热量可能比蛋白质更重要。

Abstract:

Objective To determine the nutritional status in continuous ambul atory peritoneal dialysis (CAPD) patients. Methods Fifty-two stable CAPD patients (male 32, women 20) were investigated. All patients were performed dietary survey, subjective global assessment (SGA) by semi-quantitative scale. Anthropometric measurements and their biochemical parameters including hemoglobin (HB), serum albumin (ALB), pre-albumin (PA) and C-reactive protein (CRP) as inflammation marker were measured. Results High prevalence of malnutrition 78.8% (41/52) in our CAPD patients was found based on SGA. However, on categorizing patients of malnutrition based on serum albumin, 67.3% (3-5/52) had malnutrition. By assessment based on AMC, 55.8% (29/52) had malnutrition. There was significant correlation between nutritional indices and dietary intake. DEI showed positively correlated with BMI (P<0.05), ALB (P<0.05) and PA (P<0.01), and negatively correlated with SGA(P<0.01) and CRP(P<0.05), However, DPI showed positively correlated with PA (P<0.01) . Conclusion High prevalence of malnutrition i s found in CAPD p atients. Di etary int ake is correlated with nutritional indices in CAPD patients. It is more important to have sufficient energy intake than protein intake.