中国血液净化

›› 2006, Vol. 5 ›› Issue (9): 667-670.

• 论著 • 上一篇    下一篇

维持性透析患者残存肾功能与营养状态的关系

童俊容 张 虹 王 寅 朱起之

  

  1. 510010 广州，广州军区广州总医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-09-12 发布日期:2006-09-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-09-12 Published:2006-09-12

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摘要： 目的 探讨维持性透析患者残存肾功能与患者营养状态的关系。方法 收集广州军区广州总医院肾内科2000～2004年在门诊和住院的部分维持性血液透析和腹膜透析患者各30例，计算其残存肾功能，并对治疗前后进行主观综合营养评估（SGA）和生化检查，将两者进行相关分析。结果 开始治疗时两组患者的残存肾功能差异无显著性，治疗后从6个月开始两组差异显著，24个月后差异非常显著。SGA评分，两组治疗前差异无显著性，治疗后与治疗前相比，差异非常显著。生化检查，血白蛋白治疗前后无差别，前白蛋白、转铁蛋白、纤维连接蛋白均明显下降。两组SGA评分与残存肾功能高度相关[腹膜透析 (PD)组r＝0.849，血液透析(HD)组r=0.734）。 结论 维持性透析患者的残存肾功能与患者的营养状态密切相关，保存患者较好的残存肾功能有利于患者保持较好的营养状态，从而改善患者的生存质量并提高其生存率。PD能相对较好地保存患者的残存肾功能。

关键词: 残存肾功能, 透析, 营养

Abstract:

Objective To investigate the relationship between the residual renal function and nutritional state in maintenance dialysis patients. Methods Thirty chronic renal failure(CRF) patiants who received hemodialysis (HD) therapy and 30 CRF patients who received peritoneal dialysis (PD) therapy were enrolled. The residual renal function was calculated and the nutritional state was evaluated by SGA and examination index of biochemistry in the two groups, and then the relationship between the residual renal function and the nutritional state were analyzed. Results There were no significant difference of the residual renal function and the score of SGA between two groups pre-treatment (P＞0.05). The difference of the residual renal function between the two groups was significant after 6 months and 24 months’ treatment (P＜0.05). The difference of the SGA score were significant too (P＜0.01). The serum level of pre-albumin, transferrin and fibronectin decreased significantly (P＜0.01 or P＜0.05). The change of the serum albumin level was no significant (P＞0.05).There were correlations between the SGA score and the residual renal function in two groups(HD r = 0.849,PD r = 0.734 respectively).Conclusion There were close correlation between the nutritional stats residual renal function in maintenance dialysis patients. Patients whose residual renal function are preserved better have better nutritional state, which can improve their quality of life and survival rate. PD can preserve residual renal function better than HD.

Key words: Maintenance dialysis, Nutrition

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