腹膜透析患者血钠浓度与蛋白能量消耗的相关性研究

发布时间：2018-02-04 14:35

本文关键词： 腹膜透析蛋白能量消耗血钠浓度 SGA　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨腹膜透析(PD)患者血清钠浓度与蛋白-能量消耗(PEW)的关系,为临床干预提供理论依据。方法:选择2015年6月-2016年12月于山西医科大学第一附属医院肾内科行PD患者共108例,符合入选标准88例。获取患者的基本情况包括[基础原发病因、性别、年龄、体重、身高、体重指数(BMI)、血压水平、透析龄],采用标准的技术检测患者的各项身体指标包括[上臂围(AC)、肱三头肌皮褶厚度(TSF)和上臂肌围(AMC)]等,检测生化指标包括[血清白蛋白(ALB)、血清前白蛋白(PLB)、血红蛋白(Hb)、红细胞压积(MCV)、血转铁蛋白(TF)、血总胆固醇(TC)、血甘油三酯(TG)、血肌酐(SCr)血超敏C反应蛋白(hs-CRP)、血清钾离子(K)、血钙(Ca)、血钠(Na)]等,及采取主观的综合性评估法(SGA)评测患者的营养状况。根据ISRMN的诊断标准并计算患者的PEW患病率,根据入组患者血钠浓度的均值分为A组(血Na137mmol/L)和B组(血Na"g137mmol/L),应用统计学方法分别比较两组上述指标及PEW的患病率的差异,并用pearson法分析PD患者PEW的一些指标与血钠浓度的相关性。结果:1.男性48例,女性40例,年龄20~78岁,平均(49.6±13.93)岁,透析时间3~64月,平均透析龄(16.25±13.57)月,糖尿病患者24例,占(27.3%);2.我院PEW患病率为39.7%;3.两组的性别、年龄、BMI、透析龄、血压、TSF、PLB、Hb、MCV、TF、TC、TG、SCr、K、Ca、、hs-CRP差异均无统计学意义(P0.05);4.与B组相比,A组上臂围、上臂肌围、血清白蛋白水平偏低,SGA评分偏高,差异有统计学意义(P0.01);5.PD患者血钠浓度与上臂围、上臂肌围、血清白蛋白呈正相关(P0.01),与SGA呈负相关(P0.01)。结论:PD患者PEW发生率较高,且PEW的相关指标与血清钠浓度具有一定的相关性,提示预防PD患者的低钠水平,可在一定程度上减少PEW的发生,改善患者预后,延长生命。
[Abstract]:Objective: to investigate the relationship between serum sodium concentration and protein / energy consumption (PEW) in patients with peritoneal dialysis (PDD). Methods: a total of 108 PD patients were selected from June 2015 to December 2016 in the Department of Renal Medicine, the first affiliated Hospital of Shanxi Medical University. Meet the inclusion criteria in 88 cases. Basic information obtained from the patient includes. [Basic primary causes, sex, age, weight, height, body mass index (BMI), blood pressure level, dialysis age]. [The upper arm circumference, triceps skinfold thickness (TSF), and upper arm muscle circumference (AMC), etc. [Serum albumin (ALB), serum prealbumin (PLB), hemoglobin (HB), hematocrit (MCV), transferrin (TFN), serum total cholesterol (TC). Serum triglyceride (TGG), serum creatinine (SCR), serum hypersensitive C-reactive protein (hs-CRPN), serum potassium ion (KG), serum calcium (Cam), blood sodium (Na), etc. The nutritional status of the patients was evaluated by the subjective comprehensive evaluation method (SGA). The prevalence of PEW was calculated according to the diagnostic criteria of ISRMN. The patients were divided into two groups: group A (Na 137 mmol / L) and group B (Na "g 137 mmol / L). Statistical methods were used to compare the two groups of the above indicators and the prevalence of PEW differences. The correlation between PEW and serum sodium concentration in PD patients was analyzed by pearson method. Results: 1. There were 48 males and 40 females aged 20 to 78 years. The mean age of dialysis was 49.6 卤13.93 years, the dialysis time was 3 ~ 64 months, and the average dialysis age was 16.25 卤13.57 months. There were 24 cases of diabetes mellitus, accounting for 27.3%. 2. The prevalence of PEW in our hospital was 39.7; 3. Sex, age, age, age of dialysis, blood pressure of TSF, PLB, MCV, TFT, TGN, TGG, and Ke Ke Ca. of the two groups. The results showed that the blood pressure of the two groups was higher than that of the control group. There was no significant difference in hs-CRP between the two groups (P 0.05). 4.Compared with group B, the upper arm circumference, upper arm muscle circumference and serum albumin level in group A were lower than those in group B, and the SGA scores were higher than those in group B (P 0.01). 5. Serum sodium concentration was positively correlated with upper arm circumference, upper arm muscle circumference and serum albumin, and negatively correlated with SGA (P 0.01). Conclusion the incidence of PEW is higher in patients with 7% PD. The correlation between PEW and serum sodium concentration suggested that the prevention of hyponatremia in PD patients could reduce the occurrence of PEW to a certain extent, improve the prognosis and prolong the life of PD patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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