中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (02): 90-94.doi: 10.3969/j.issn.1671-4091.2023.02.003

• 临床研究 • 上一篇    下一篇

维持性血液透析患者老年营养风险指数与临床指标的相关性分析

汪  炜  石 瑞   李秀勇   白友为   刘 智   梁绍钦   陈 雷   唐晓飞   李 激   郭玉文  袁 亮   王德光   

  1. 242099 宣城，1宣城市人民医院血液净化中心
    230601 合肥，2安徽医科大学第二附属医院肾内科
    236029 阜阳，3阜阳市第二人民医院血液净化中心 
    237008 六安，4六安市人民医院肾内科
    232007 淮南，5安徽理工大学第一附属医院肾脏内科
    236804 亳州，6亳州市人民医院血液净化中心
    230071 合肥，7金楠肾脏病专科医院液净化中心
    243099 马鞍山，8马鞍山人民医院血液净化中心
    244099 铜陵，9铜陵市人民医院血液净化中心 
    231501 合肥，10庐江县人民医院肾内科

  • 收稿日期:2022-07-14 修回日期:2022-11-23 出版日期:2023-02-12 发布日期:2023-02-12
  • 通讯作者: 王德光 E-mail:wangdeguang@ahmu.edu.cn
  • 基金资助:
    安徽医科大学临床与前期共建项目;安徽医科大学科研基金;安徽医科大学第二附属医院临床研究培育计划项目

Associations between geriatric nutritional risk index and clinical characteristics in maintenance hemodialysis patients

WANG Wei, SHI Rui, LI Xiu-yong, BAI You-wei, LIU Zhi, LIANG Shao-qin, CHEN Lei, TANG Xiao-fei, LI Ji, GUO Yu-wen, YUAN Liang, WANG De-guang   

  1. 1Blood Purification Center, XuanCheng People’s Hospital, Xuancheng 242000, China; 2Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei 230601, China; 3Blood Purification Center, Fuyang Second People’s Hospital, Fuyang 236029, China; 4Department of Nephrology, Luan People’s Hospital, Luan 237006, China; 5Department of Nephrology, The First Hospital of Anhui University of Science and Technology, Huainan 232007, China; 6Blood Purification Center, Bozhou People’s Hospital, Bozhou 236814, China; 7Blood Purification Center, Hefei Jinnan Specialist Hospital for Nephrology, Hefei 230071, China; 8Blood Purification Center, Maanshan People’s Hospital, Maanshan 243099, China; 9Blood Purification Center, TongLing People’s Hospital, Tongling 244099, China; 10Department of Nephrology, Lujiang People’s Hospital, Hefei 231501, China
  • Received:2022-07-14 Revised:2022-11-23 Online:2023-02-12 Published:2023-02-12
  • Contact: 230601 合肥，2安徽医科大学第二附属医院肾内科 E-mail:wangdeguang@ahmu.edu.cn

PDF

213

摘要： 目的  探讨维持性血液透析(maintenance hemodialysis,MHD)患者老年营养风险指数(geriatric nutritional risk index,GNRI)与临床指标的相关性。 方法 本研究为多中心横断面研究。纳入2019～2020年安徽省宣城市人民医院血液净化中心等29家透析中心2678例MHD患者，收集相关人口学特征、原发病、实验室检查等资料，其中依据白蛋白、身高、体质量等计算老年营养风险指数值，根据老年营养风险指数值分为高营养风险组(GNRI＜82)，中营养风险组(82≤GNRI＜92)，低营养风险组(92≤GNRI≤98)，无营养风险组(GNRI＞98)，单因素方差分析4组间临床指标的差异，多元线性回归分析老年营养风险指数与临床指标的相关性。 结果 MHD患者中存在营养风险的占40.3%(1084/2687)，高、中、低营养风险占比分别为3.0%、13.5%和23.7%；Pearson相关分析发现年龄(r=-0.101，P＜0.001)、超敏C反应蛋白(r =-0.195，P =0.002)与GNRI呈负相关，血红蛋白(r=0.266，P＜0.001)、肌酐(r=0.225，P＜0.001)、三酰甘油(r =0.147，P＜0.001)、低密度脂蛋白(r=0.089，P＜0.001)、胆固醇(r=0.060，P =0.002)、血镁(r=0.113，P＜0.001)、血磷(r=0.127，P＜0.001)、甲状旁腺激素(r=0.051，P =0.008)与GNRI呈正相关。多元线性回归分析发现MHD患者GNRI与血清肌酐(β=0.070，P＜0.001)、三酰甘油(β=0.070，P＜0.001)、低密度脂蛋白(β=0.034，P=0.009)独立相关。 结论 维持性血液透析患者营养风险比例高，老年营养风险指数是反映血液透析患者营养状态的有用指标。

关键词: 老年营养风险指数, 血液透析, 营养不良

Abstract: Objective To evaluate the associated between Geriatric Nutritional Risk Index (GNRI) and clinical characteristics in maintenance hemodialysis (MHD) patients.  Methods  Two thousand six hundred and seventy-eight patients in MHD were recruited. Clinical characteristics of the patients were collected. We divided patients into the highest GNRI group (>98), considered to have no risk of malnutrition, the high GNRI group (92≤GNRI≤98), considered to have a low risk of malnutrition, median GNRI group (82≤GNRI＜92), considered to have a median risk of malnutrition, and low GNRI group (＜82), considered to have a high risk of malnutrition. Pearson correlation analyses and multiple linear regression analyses were conducted.  Results  One thousand and eighty-four patients (40.3%) were at risk of malnutrition. Pearson analysis showed that age (r=-0.101, P＜0.001) and hypersensitive c reactive protein (hsCRP) (r=-0.195, P=0.002) were negatively correlated with GNRI. Hemoglobin (r=0.266, P＜0.001), serum creatinine (r=0.225, P＜0.001),  triglyceride (r=0.147, P＜0.001), low density lipoprotein (r=0.089, P＜0.001), cholesterol (r=0.060, P=0.002), serum magnesium (r=0.113, P＜0.001), serum phosphorus (r=0.127, P＜0.001), parathyroid hormone (r=0.051, P=0.008) were positively correlated with GNRI. Multivariate logistic regression analysis shown that serum creatinine (β=0.070, P＜0.001), triglyceride (β=0.070, P＜0.001) and low density lipoprotein (β=0.034, P=0.009) were significantly associated with GNRI.  Conclusions  GNRI may be a reasonable indicator for assessment and monitoring of nutritional status in MHD patients. 

Key words: Geriatric nutritional risk index, Hemodialysis, Malnutrition

中图分类号: