不同营养评价方法对血液透析患者营养状况评价的比较

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Ngg2002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％一62．5％，实验室检查指标评价方法12．5％一80％；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。NP~S2002营养风险筛查与主观全面评价（SGA）一致性检验的k=O．319，P〈0．05，灵敏度78．5％，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；NgS2002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。%[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.