中国全科医学2011，Vol.14Issue(3)：232-235,4.
维持性血液透析患者两种类型营养不良评价方法的比较研究
The Comparative Study of Evaluating Method for Two Kinds of Malnutrition in Patients with Maintenance Hemodialysis
摘要
Abstract
Objective There are two kinds of malnutrition in patients on maintenance hemodialysis ( MHD ). One is type Ⅰ malnutrition caused by taking less protein and energy, the other is type II malnutrition caused by inflammation. Although the cause of malnutrition is different, we use the same parameters to evaluate, such as MIS, 7 - point SGA, serum total protein, albumin, transferrin, ferritin, total iron binding capacity, serum creatinine, uric acid, urea nitrogen and haemoglobin, body mass index ( BMI ), triceps skinfold ( TSF ), mid - arm circumference ( MAC ) and mid - arm muscle circumference ( MAMC ). We aim to study these malnutrition evaluating methods to find whether they are fit to evaluate both type Ⅰ and type Ⅱ of malnutrition. Methods 124 patients admitted in Hemo - purified Center of the first people's hospital of Wenling from July 2009 to October 2009 were involved in the study. MIS ＞0 was regarded as the criteria of malnutrition, and the predialysis CRP ( hs - CRP )≥5 mg/L was regarded as the criteria of microinflammation. MHD patients with MIS ＞ 0 and hs - CRP ＜ 5 mg/L were classified as type Ⅰ malnutrition, patients with MIS ＞0 and hs - CRP ≥5 mg/L were classified as type Ⅱ malnutrition. Meanwhile, 30 healthy people were involved as the control group. Correlation between nutrition and inflammatory parameters in each group ( including IL - 6 and hs - CRP before and after dialysis ) and correlation between albumin and other nutrition parameters were analyzed. Results The incidences of type Ⅰ malnutrition and type Ⅱ malnutrition were respectively 44. 35％ and 55. 65％. The malnutrition parameter correlated significantly with inflammation parameters in type Ⅱ malnutrition group ( P ＜ 0. 05 ), however, there was no such correlation in type Ⅰ malnutrition group. And albumin correlated significantly with other malnutrition parameters in type Ⅱ malnutrition group, too. But albumin only correlated significantly with MIS in type Ⅰ malnutrition group ( P ＜0. 05 ). Albumin in control group showed no correlation with any of the parameters. Conclusion Malnutrition and inflammation are common complication in MHD patients. SGA, anthropometry, biochemical assays and nutrition parameters are only fit to evaluate type Ⅱ malnutrition, MIS could evaluate both type Ⅰ and Ⅱ malnutrition group.关键词
肾透析/营养不良/炎症/营养不良-炎症评分分类
医药卫生引用本文复制引用
王文龙,郑丹,张近波,李传光,董志兵,李云生,程勇军,柯颖杰,吴光华,郝世军,陈晓莉,吴小芬,罗筱云..维持性血液透析患者两种类型营养不良评价方法的比较研究[J].中国全科医学,2011,14(3):232-235,4.基金项目
温岭市科技计划项目基金(2009WLCB0085) （2009WLCB0085）
