微型营养评定法在维持性血液透析患者中的应用

摘要

目的:尝试用新型微型营养评定(MNA)方法筛查维持性血液透析患者营养不良风险的发生率.方法:取该院诊断明确的维持性血液透析患者53例,按MNA得分分为营养不良及营养不良危险组(A组)和营养状况正常组(B组),并分别记录人体测量、人体组成、生化指标的情况.结果:A组与B组的人体测量指标和人体组成比较均有显著差异(P＜0.05),分别为体重指数(BMI)[(20.7±2.2)kg/m2vs(23.5±3.0)kg/m2]、肱三头肌皮褶厚度(TSF)[(4.7±1.6)cmvs(5.9±1.6)cm]、上臂围(AC)[(25.3±2.0)cm vs(27.2±2.3)cm]、小腿围(CC)[(33.1±2.2)cm vs(34.5±2.1)cm]、非脂肪组织(FFM)[(45.1±7.3)kg vs(49.8±8.0)kg]、脂肪组织(FM)[(10.8±4.6)kg vs(14.2±4.7)kgl,但生化指标(血清白蛋白、肌酐、尿素氮、血红蛋白、三酰甘油、总胆固醇)比较,差异无统计学意义(P＞0.05).结论:MNA法与各项人体测量及人体组成指标相关性良好,可结合实验室生化指标综合评价维持性血液透析患者营养状况.%Objective: To find out the morbidity of maintanance hemodialysis patients' risk of malnutrition by means of MNA and analyze the consistency between traditional index and MNA score.Methods: According to the score of MNA, 53 maintanance hemodialysis patients were divided into two groups, group A (malnutrition and malnutrition risk), group B (well nourished).The records included anthropometry, body composition, as well as biochemical markers.Results: There were significant differences on anthropometry and body composition between two groups (P＜0.05), BM1[(20.7卤22) kgin2vs (235卤3.0) kg/m2], TSF[(4.7卤1.6) cm vs (5.9卤1.6) cm, AC[(25.3卤2.0) cm vs (27.2卤2.3) cm], CC[(33.1卤2.2) cm vs (34.5卤2.1) cm, FFM[(45.1卤 7.3) kg vs (49.8卤8.0) kg], FM[(10.8卤4.6) kg vs (14.2卤4.7) kg], there was no significant difference on the biochemical indicator (serum albumin, creatinine, usea nitrogen, hemoglobin, triacylglycerol, total cholesterol) in the two groups (P＞0.05).Conclusion: MNA is a good method that can be used to evaluate the nutritional state in maintanance hemodialysis patients.