新疆医科大学学报

目的了解维持性血液透析(maintenance hemodialysis,MHD)患者营养状况及发生营养不良的常见膳食危险因素,为针对性营养干预提供依据。方法采用主观全面评定法(SGA)和营养不良风险筛查2002(NRS-2002)评估150例MHD患者的营养状态,同时采用连续3d24h膳食回顾法了解实际摄入内容,并进行必要的人体测量及营养生化指标检测。结果 4.00%(6例)的患者为C级,属重度营养不良;37.33%(56例)的患者为B级,属轻中度营养不良。29.33%(44例)的患者NRS-2002评分≥3分,存在营养不良风险。SGA和NRS-2002筛查结果差异无统计学意义(χ2=18.155,P=0.109)。单一指标营养不良的发生率为6%～75%。MHD患者的热能、蛋白质、脂肪和大部分维生素及矿物质摄入均明显低于膳食推荐摄入量(P<0.05)。单因素危险因素分析结果表明,透析时间和高龄与营养不良发生相关(P<0.05)。结论 MHD患者营养不良发生比例很高,热能和多种营养素摄入不足。透析时间和高龄可能是导致营养不良的重要原因。

Objectives To investigate the nutritional status of maintenance hemodialysis patients and analyze the diet risk factors of malnutrition.Methods Subjective global assessment(SGA) and nutritional risk screening 2002(NRS-2002) were used to evaluate the nutritional status of 150 patients undergoing maintenance hemodialysis,A 3-day retrospective 24-hour diet survey was carried out.Results SGA result showed that 6 patients(4.00%) were at C grade(severe malnutrition),and 56 patients(37.33%) were at B grade(mild or moderate malnutrition).NRS-2002 result showed that 44 patients(29.33%) were malnutritional risk with NRS-2002 score≥ 3.There was no significant difference between the two methods of screening results(χ2=18.155,P=0.109).Biochemistry and somatometric measurement showed that the malnutrition incidence was 6%~75%.Food intake survey indicated that the intakes of energy,protein,fat and other nutrients were significantly lower in maintenance hemodialysis patients than in normal population(P<0.05).Age and dialysis duration was positively correlated with the incidence of malnutrition(P<0.05).Conclusion The incidence of malnutrition in maintenance hemodialysis patients is high,and the intakes of energy and other nutrients are insufficient.Age and dialysis duration maybe the important cause for malnutrition.