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不同营养评价方法对血液透析患者营养状况评价的比较

作  者:
赵霞;张初烨;高艳均;张力
单  位:
北京积水潭医院营养科;北京积水潭医院血液透析中心
关键词:
血液透析;营养不良;营养评价
摘  要:
目的:探讨不同营养评价方法对血液透析治疗患者营养状况评价的相关性。方法:采用NRS2002对40例患者进行筛查,并使用全面主观评定法(SGA)、人体测量指标(身高、体重、三头肌皮褶厚度、上臂围)、实验室检查指标(总蛋白、白蛋白、前白蛋白、血红蛋白、总淋巴细胞计数)进行营养评价。结果:营养不良发生率分别为SGA42.5%,人体测量指标评价方法42.5%—62.3%,实验室检查指标评价方法12.5%—80%;SGA与TP、ALB、PA、TLC具有相关性,与Hb的相关性稍弱(P=0.07);而与BMI、AMC、TSF相关性差。NRS2002营养风险筛查与主观全面评价(SGA)一致性检验的k=0.319,P<0.05,灵敏度78.3%,特异性52.9%。结论:各种营养评价方法对HD患者评价结果间存在差异;就SGA来说,患者的TP、ALB、PA、TLC较BMI、AMC、TSF可靠好;NRS2002对HD患者的营养评价方面也具有一定的应用价值;应该将SGA与单一指标相结合,综合应用评价HD患者营养状况。
译  名:
Application of Different Methods in Nutrition Assessment for Patients with Hemodialysis
作  者:
ZHAO Xia1,ZHANG Qing-ye1,GAO Yan-jun2,ZHANG Li2 (1 Department of Nutrition,Beijing Jishuitan Hospital,Beijing 100035,China; 2 Hemodialysis Center,Beijing Jishuitan Hospital,Beijing 100035,China)
关键词:
hemodialysis;malnutrition;nutrition assessment
摘  要:
【Objective】 To study the nutritional status of patients with hemodialysis,and to compare the difference of assessment results obtained with different methods.【Method】With NRS-2002,the nutritional status of patients with hemodialysis were assessed by NRS-2002,SGA,body physical measurement,and laboratory tests.【Result】 Different assessment methods showed different malnutrition rates.The incidences were 42.5%(SGA),42.5%—62.3%(body physical measurement),and 12.5%—80%(laboratory tests),respectively.The correlations of SGA with other nutritional assessment methods were different.【Conclusion】 Compared with SGA,laboratory tests were more appropriate than body physical measurement for patients with hemodialysis.NRS-2002 was useful for those HD patients.These methods should be comprehensively applied in nutrition assessment of patients with hemodialysis.

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