中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (06): 353-356.doi: 10.3969/j.issn.1671-4091.2016.06.010

• 临床研究 • 上一篇    下一篇

维持性血液透析患者人体成分分析评估营养状况

余毅,刘书凤,王琰,林曰勇,陈今,孙淑清   

  1. 南京军区福州总医院血液净化科
  • 收稿日期:2015-09-07 修回日期:2016-03-27 出版日期:2016-06-12 发布日期:2016-06-19
  • 通讯作者: 余毅 yuyicn@126.com E-mail:yuyicn@126.com

Body composition analyses for the evaluation of nutritional status in maintenance hemodialysis patients

  • Received:2015-09-07 Revised:2016-03-27 Online:2016-06-12 Published:2016-06-19

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摘要： 目的分析维持性血液透析(maintenance hemodialysis，MHD)患者人体成分，评估营养状况。方法选择MHD 患者57 例，应用人体成分分析仪(Body composition monitor，BCM)测量人体成分，检测患者透析前血清总胆固醇、三酰甘油、白蛋白、血红蛋白、血肌酐等生化指标，以体质量指数(body mass index，BMI)、单位体表面积脂肪含量、瘦组织含量的均值分组进行比较及相关分析。结果BMI 高组(BMI≥21.68kg/m2)与BMI 低组(BMI＜21.68 kg/m2)比较，前者单位面积脂肪组织含量较高(t=4.327，P＜0.001)，BMI 与单位面积脂肪含量呈正相关(r=0.588,P＜0.001)。2 组单位面积瘦组织含量差异无统计学意义(t=0.892，P=0.376)，BMI 与单位面积瘦组织含量不存在直线相关(r=-0.109，P=0.419)。单位面积脂肪含量高组(≥12.29 kg/m2)与单位面积脂肪含量低组(＜12.29 kg/m2)比较，前者胆固醇(t=2.882，P=0.006)、三酰甘油(t=2.040,P=0.047)、血红蛋白(t=3.857，P＜0.001)均高于后者；单位面积脂肪含量与胆固醇(r=0.370，P=0.010)、三酰甘油(r=0.403，P=0.005)、血红蛋白(r=0.405，P=0.002)呈正相关。单位面积瘦组织含量高组(≥22.80 kg/m2)与单位面积瘦组织含量低组(＜22.80 kg/m2)比较，前者血肌酐(t=2.515，P=0.015)、血清白蛋白(t=2.189,P=0.033)均高于后者；单位面积瘦组织含量与血肌酐(r=0.416，P=0.001)、白蛋白(r=0.315，P=0.018)呈正相关。结论BCM 能简便、准确、无创地评估MHD患者人体成分,有效评估营养状况。

关键词: 生物电阻抗, 人体成分, BMI, 维持性血液透析

Abstract: Objective To assess the nutritional status by body composition monitor (BCM) in maintenance hemodialysis (MHD) patients. Method A total of 57 MHD patients were enrolled in this study. Their body composition and laboratory data were measured and collected. Patients were divided into 2 groups according to the mean value of BMI. Fat and muscle content per body surface unit and laboratory data were then compared between the 2 groups. Result Fat content per body surface unit was higher in the high BMI group (BMI ≥21.68 kg/m2) than in the BMI low group (BMI ＜21.68 kg/m2) (t=4.327, P＜0.001); univariate regression analysis found that BMI value was positively correlated with fat content per body surface unit (r=0.588, P＜0.001). The difference in muscle content per body surface unit between high BMI group and low BMI group was statistical insignificant (t=0.892, P=0.376), and BMI value had no linear correlation with muscle content per body surface unit (r=-0.109, P=0.419). Cholesterol (t=2.882, P=0.006), triglyceride (t=2.040, P= 0.047) and hemoglobin (t=3.857, P＜0.001) were higher in the high fat content per body surface unit (≥12.29 kg/m2) group than in the low fat content per body surface unit (＜12.29 kg/m2); fat content per body surface unit was positively correlated with cholesterol (r=0.370, P=0.010), triglyceride (t=0.403, P=0.005) and hemoglobin (r=0.405, P=0.002) levels. Serum creatinine (t=2.515, P=0.015) and albumin (t=2.189, P=0.033) were higher in the high muscle content per body surface unit group (≥22.80 kg/m2) than in the low muscle content per body surface unit group (＜22.80 kg/m2); muscle content per body surface unit was positively correlated with serum creatinine (r=0.416, P=0.001) and albumin (r=0.315, P=0.018). Conclusion The nutritional status in MHD patients could be conveniently and accurately assessed by BCM.

Key words: bioelectrical impedance, body composition, BMI, Maintenance hemodialysis