中国血液净化

›› 2005, Vol. 4 ›› Issue (4): 187-190.

• 论著 • 上一篇    下一篇

血液透析患者营养状态与生存质量关系研究

郑智华 马祖等 张涤华 沈清瑞 余学清   

  1. 510080 广州，中山大学附属第一医院肾内科，教育部肾脏病重点实验室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-04-12 发布日期:2005-04-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-04-12 Published:2005-04-12

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摘要：

目的 探讨血液透析患者营养状态和生存质量之间的关系，为改善患者的营养状况以提高生 存质量提供临床依据。方法 使用改良定量主观整体评估（MQSGA）表评估患者营养状况；同时测定患者Hb、ALB、握力、IGF-1；使用KDQOL-SFTM表调查114例血液透析患者生存质量，根据Hays Ron D等提供的方法计算生存质量评分；统计学分析营养指标与生存质量评分之间的相关关系。结果 ①按MQSGA评估，MQSGA>10作为营养不良的评估，营养不良发生率为64.1%；生存质量评分KDTA为(64.8±6.3)，SF-36为(74.8±10.2)；②MQSGA与肾病、透析相关生存质量（KDTA）总分及其分支领域：症状与不适、认知功能、睡眠；和一般健康相关生存质量(SF-36) 总分及其分支领域：体能、体力所致工作和生活受限、疼痛、总体健康状况、情感问题对工作和生活的影响呈显著相关性；③Hb与KDTA总分及其分支领域：症状与不适、肾病对日常生活的影响、认知功能、社交质量、性功能、睡眠；和SF-36总分及其分支领域：体能、总体健康状况、社会功能、精力状况呈现显著相关性；④ALB与KDTA总分及其分支领域：症状与不适、肾病对日常生活的影响、睡眠；SF-36总分及其分支领域：体能、体力所致工作和生活受限、总体健康状况、精力状况呈显著相关性；⑤握力与KDTA总分及其分支领域：症状与不适、肾病对日常生活的影响、睡眠；和SF-36总分及其分支领域：体能、疼痛、总体健康状况呈现显著相关关系。而 IGF-1 仅与体能、总体健康状况、精力状况呈相关关系。结论 ① 血液透析患者营养状态与生存质量的多个领域存在密切关系，是影响血液透析患者生存质量的重要因素，这提示改善血液透析患者营养状况能提高患者生存质量；② MQSGA、ALB、Hb、握力均能客观、定量评估透析患者的营养状态，尤其MQSGA较好地评估营养不良并预示生存质量；而握力则最简单、实用预示营养不良和生存质量，并无创和无需费用。

关键词: 营养, 生存质量, 血液透析

Abstract:

Objective To evaluate quality of life and nutritional status, and analysis their relationship in hemodialysis patients. Methods Quality of life was surveyed with KDQOL-SFTM questionnaire, and nutritional indexes such as MQSGA, haemoglobin, albumin and handgrip strength were assayed in 114 patients of our hemodialysis center. Results ①The incidence of malnutrition was 64.1%; score of KDTA was(64.8±6.3),and SF-36 was (74.8±10.2). There were significant corelation between MQSGA and KDTA, symptom/problem list, cognitive function, sleep, SF-36, physical functioning, role-physical, pain, general health, social function and energy/fatigue; ② It demonstrated significant correlation between haemoglobin and KDTA, symptom/problem list, effects of kidney disease, cognitive function, quality of social interaction, sexual function, sleep, SF-36, physical functioning, general health, social function and energy/fatigue; ③ It also showed significant correlation between albumin and KDTA symptom/problem list, effects of kidney disease, sleep, SF-36, physical functioning, role-physical, general health and energy/fatigue; ④ Furthermore, there were significant correlations between handgrip strength and KDTA, symptom/problem list, effects of kidney disease, sleep, SF-36, physical functioning, pain and general health. Conclusions Our data suggest that nutritional status impact on quality of life in different items. MQSGA should be good predictor of nutritional status and quality of life in hemodialysis patients, and handgrip strength be a simple and practicable index of nutrition. 

Key words: Quality of life, Hemodialysis

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