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目的:调查持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者综合营养情况,并进行相关影响因素分析。方法:56例CAPD患者按透析龄分为透析龄<36个月组和透析龄≥36个月两组,比较各营养代谢指标的差异,并进行相关分析。行半定量主观综合营养评分(subjective global assessment,SGA);生化指标包括:血清白蛋白(AlB)、前白蛋白(PreA)、转铁蛋白(Tf)、血红蛋白(Hb)、胆固醇(TC)、甘油三酯(TG)、C反应蛋白(CRP)、血肌酐、血尿素氮、24 h腹透液和尿液中的尿素氮和肌酐等,计算尿素清除指数(Kt/V)、残余肾功能(residual renal function,RRF)。结果:长透析龄组的SGA评分高于短透析龄组、血清营养指标低于短透析龄组(P<0.05),RRF、Kt/V低于短透析龄组(P<0.05),CRP高于短透析龄组(P<0.05)。透析时间与白蛋白、前白蛋白、转铁蛋白、血红蛋白、Kt/V、RRF呈负相关,与CRP、SGA评分呈正相关。结论:随着透析龄的延长,残余肾功能逐步衰退,透析充分性降低,助长炎症反应,加重营养不良。
Objective: To investigate the nutritional status of patients under continuous ambulatory peritoneal dialysis (CAPD) and to analyze the related factors. Methods: Fifty-six patients with CAPD were divided into dialysis age <36 months and dialysis age> 36 months according to the dialysis age. The differences of various nutritional and metabolic indexes were compared and analyzed. The subjective global assessment (SGA) was performed by semi-quantitative analysis. Biochemical parameters included serum albumin (AlB), preA, Tf, Hb, TC, Triglyceride (TG), C-reactive protein (CRP), serum creatinine, blood urea nitrogen, blood urea nitrogen and creatinine in 24 h dialysate and urine were calculated. Kt / V, residual renal function (residual renal function, RRF). Results: The SGA score of long dialysis group was higher than that of short dialysis group, serum nutrition index was lower than that of short dialysis group (RR), Kt / V was lower than that of short dialysis group (P <0.05) In the short dialysis age group (P <0.05). Dialysis time and albumin, prealbumin, transferrin, hemoglobin, Kt / V, RRF was negatively correlated with CRP, SGA was positively correlated. Conclusion: With the extension of dialysis age, the remnant renal function gradually declines, the adequacy of dialysis decreases, which promotes the inflammatory reaction and aggravates malnutrition.