摘要
目的分析血液透析(hemodialysis,HD)联合血液透析滤过(hemodialysis filtration,HDF)对终末期肾病(end stage renal disease,ESRD)患者营养状况影响及相关因素。方法132例接受HD联合HDF治疗的ESRD患者依据改良定量主观整体评估量表(MQSGA)评估营养状况分为营养不良组和营养正常组。比较2组患者生化指标,采用二分类Logistic回归分析影响营养状况的因素。结果MQSGA评估显示,干预前ESRD患者营养不良69例,营养不良发生率为52.3%;干预后营养不良51例,营养不良发生率为38.6%,干预后营养不良发生率降低,差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,尿素清除指数(Kt/V)(95%CI=0.112~4.010,β=-0.399,P=0.043)、血红蛋白(95%CI=0.010~0.167,β=-4.589,P=0.001)、白蛋白(95%CI=0.003~0.271,β=-3.632,P=0.002)及前白蛋白(95%CI=0.001~0.077,β=-5.083,P=0.000)是常规HD联合HDF治疗ESRD患者发生营养不良的保护因素,尿素氮(95%CI=3.286~50.240,β=3.706,P=0.004)是危险因素。根据Logistic多因素分析结果建立判别营养不良的预测模型为Y=4.686-0.399X1-4.589X2+3.706X3-3.62X4-5.083X5(X1为Kt/V,X2为血红蛋白,X3为尿素氮,X4为白蛋白,X5为前白蛋白)。结论ESRD患者营养不良发生率较高,采用HD联合HDF治疗有利于改善患者营养状况,营养不良发生率与Kt/V、血红蛋白、尿素氮、白蛋白及前白蛋白水平有关。
Objective To analyze the effect of hemodialysis(HD)combined with hemodialysis filtration(HDF)on nutritional status and related factors in patients with end-stage renal disease(ESRD).Methods 132 ESRD patients receiving HD combined with HDF were selected for the study.They were divided into the malnutrition group and the nutritional normal group according to the Modified quantitative subjective global assessment scale(MQSGA).The biochemical indicators of the two groups were compared,and the influencing factors affecting the nutritional status were analyzed by dichotomous Logistic regression.Results MQSGA assessment showed that 69 patients had malnutrition before the intervention and the incidence of malnutrition was 52.3%,and 51 patients had malnutrition after the intervention and the incidence of malnutrition was 38.6%,respectively.The incidence of malnutrition in patients decreased after the intervention,and the difference was statistically significant(P<0.05).Logistic multifactor analysis showed that urea clearance index(Kt/V)(95%CI=0.112~4.010,β=-0.399,P=0.043),hemoglobin(95%CI=0.010~0.167,β=-4.589,P=0.001),albumin(95%CI=0.003~0.271,β=-3.632,P=0.002)and prealbumin(95%CI=0.001~0.077,β=-5.083,P=0.000)were protective factors for the development of nutritional disorders in ESRD patients with conventional HD combined with HDF,while urea nitrogen(95%CI=3.286~50.240,β=3.706,P=0.004)was a risk factor.The prediction model to discriminate nutritional disorders based on the results of Logistic multifactorial analysis was Y=4.686-0.399X1-4.589X2+3.706X3-3.62X4-5.083X5(X1 is Kt/V,X2 is hemoglobin,X3 is urea nitrogen,X4 is albumin,and X5 is prealbumin,respectively).Conclusion The incidence of malnutrition in ESRD patients is high,and treatment with HD combined with HDF is beneficial to improve the nutritional status of patients.The incidence of malnutrition is related to Kt/V,hemoglobin,urea nitrogen,albumin and prealbumin levels.
作者
吕娟
王淑领
尚赛男
李理
LV Juan;WANG Shu-ling;SHANG Sai-nan;LI Li(Shuangqiao Hospital,Chaoyang District,Beijing 100024,China)
出处
《河北北方学院学报（自然科学版）》
2023年第4期14-18,共5页
Journal of Hebei North University:Natural Science Edition
关键词
血液透析
血液透析滤过
营养不良
影响因素
hemodialysis
hemodialysis filtration
malnutrition
influencing factor
作者简介
吕娟(1984-),女,河北石家庄人,主治医师,研究方向:维持性血液透析患者的管理及其并发症的治疗。
