生物电阻抗与多种营养评价法对血液透析患者营养状况的对比研究

发布时间：2018-02-24 17:41

本文关键词： 生物电阻抗改良定量主观综合评价体质指数营养不良相位角　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:使用多种方法综合评价维持性血液透析(maintenance hemodialysis,MHD)患者的营养状况,探讨生物电阻抗(Bioelectrical impedance analysis,BIA)指标对血液透析营养评估的有效性,并分析营养不良发生的相关因素。方法:本研究为横断面观察性研究。分别使用生物电阻抗分析法、改良定量主观综合评价法(Modified quantitative subjective global assessment,MQSGA)、体质指数(Body mass index,BMI)及同期实验室检查对我院规律门诊行血液透析3月以上的患者进行营养评估。结果:共97名患者纳入研究。以MQSGA标准评估我院血液透析营养不良发生率为57.732%,以身体细胞总量(Body Cell Mass,BCM)法(BIA主要指标)评估营养不良发生率为64.948%,BMI中以BMI2法(BMI23kg/m2)评估营养不良发生率为65.979%,三者对营养不良检出率相似,两两之间差异无统计学意义(P0.05)。在BIA的人体成分指标中,以水肿指数(ECW/TBW)0.39为非水肿组,"g0.39为水肿组,两组间细胞内水(Intracellular Body Water,ICW)、细胞外水(Extracellular Body Water,ECW)、细胞总水(Total Body Water,TBW)差异无统计学意义(P0.05);在水肿组中,TBW升高仅有1人,19人正常,25人降低;ECW/TBW与HB、SCr、UA、ALB、PALB呈显著负相关关系(P0.05)。相位角(Phase Angle,PA)与HB、SCr、BUN、UA、ALB、PALB、BCM呈正相关关系(P0.05),与ECW/TBW、MQSGA呈负相关关系(P0.05)。经多元逐步线性回归分析提示,MQSGA评分与PA(P=0.005)、BMI(P=0.001)、PALB(P=0.010)、透析龄(P=0.000)独立相关。当hs-CRP增加时,PALB、SCr减少,而BMI、体脂肪、体脂百分比(percent body fat,PBF)随着hs-CRP的增加而增加。结论:BCM、MQSGA及BMI2均可用于评价MHD的营养状态,三者检出率相当。BIA指标中的BCM、PA与血液透析患者营养状态密切相关。PA、BMI、PALB、透析龄是MHD营养状况的独立影响因素。微炎症状态与透析患者营养状态密切相关。
[Abstract]:Objective: to evaluate the nutritional status of maintenance hemodialysis patients with maintenance hemodialysis (MHD) by a variety of methods, and to explore the effectiveness of bioelectrical impedance analysis (BIA) in the assessment of hemodialysis nutrition. Methods: this study was a cross-sectional observational study. Bioelectrical impedance analysis was used to analyze the incidence of malnutrition. The modified quantitative subjective global assessmentus MQSGAA, body mass index (BMI) and laboratory examination were used to evaluate the nutritional status of patients who underwent hemodialysis in our hospital on March. Results: 97 patients were included in the study. The incidence rate of dystrophy in hemodialysis was 57.732in our hospital according to MQSGA standard, and the main index of BIA was body Cell BCM).) the incidence rate of malnutrition was 64.948. The incidence rate of malnutrition was 65.979 by BMI2 (23kgm2BMI23kgm2). The detection rate is similar. There was no significant difference between the two groups (P 0.05). In BIA, the Edema index (Edema index) was 0.39 as non-edema group, and "g0.39 was edema group. There was no significant difference between the two groups in intracellular Body, extracellular Body, total Body Body and TBWs, but in the edema group, there was a significant negative correlation between the elevation of TBW and ECW / TBW and the decrease of ECW / TBW in 19 normal persons (P < 0.05), and a significant negative correlation between ECW / TBW and ALBPALB in HBSCRSCrWUAUAA / ALBPALB (P < 0.05). There was a positive correlation (P0.05) and a negative correlation with the MQSGA of ECW / TBWN MQSGA. The multiple stepwise linear regression analysis showed that the score of MQSGA was correlated with PALBP0.001PALBP0. 010 (P 0. 0000). BMI, body fat, percentage of body fat increased with the increase of hs-CRP. Conclusion: BCM MQ SGA and BMI2 can be used to evaluate the nutritional status of MHD. The positive rate of BCM-PA was the same as that of BIA. The nutritional status of hemodialysis patients was closely related to BCM-PA. The age of dialysis was an independent factor affecting the nutritional status of MHD, and the microinflammatory state was closely related to the nutritional status of hemodialysis patients.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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