论文部分内容阅读
目的前瞻性观察长期持续性非卧床腹膜透析(CAPD)患者的营养状态及其引起营养不良的因素。方法采用主观整体营养评估法(SGA)结合体表标志测量及有关生化检查综合判断患者的营养状态。结果 56例患者中,营养良好者26例(46.4%);轻～中度营养不良者22例(39.3%);重度营养不良者8例(14.3%)。其中,重度营养不良多发生在60岁左右透析患者。109例次的观察显示,SGA除与相当于蛋白分解率的蛋白质摄入量(nPNA)呈正相关外,也与尿素KT/V(KT/V)与肌酐清除率(CC)及单位透析剂量(PV/BSA)呈正相关(P<0.01)。结论营养不良主要与透析剂量(PV)绝对或相对不足的引起透析效能下降有关,后者进一步导致蛋白质摄入量不足,因此,预防营养不良的关键措施在于掌握恰当的透析剂量,保持足够的透析效能。
Objective To prospectively observe the nutritional status of patients with long-term ambulatory peritoneal dialysis (CAPD) and the factors that cause malnutrition. Methods The subjective nutrition assessment (SGA) combined with body surface marker measurements and biochemical tests to determine the nutritional status of patients. Results Of the 56 patients, 26 (46.4%) were well-nourished, 22 (39.3%) had mild to moderate malnutrition, and 8 (14.3%) had severe malnutrition. Among them, severe malnutrition occurred in patients over the age of 60 dialysis. A total of 109 observations showed that SGA was positively correlated with nPNA and protein KT / V (KT / V) and creatinine clearance (CC) and unit dialysis dose PV / BSA) was positively correlated (P <0.01). Conclusions Malnutrition is mainly due to the absolute or relative deficiency of dialysis dose (PV), which leads to the decrease of dialysis efficiency. The latter result in insufficient protein intake. Therefore, the key measures to prevent malnutrition are to master the appropriate dialysis dose, maintain adequate dialysis efficacy.