维持性血液透析患者营养状况评估方法的比较

摘要

目的 比较研究主观整体营养评估(SGA)、改良定量的SGA(MQSGA)和营养不良-炎症评分(MIS)3种营养评估方法在维持性血液透析(MHD)患者营养评估中的作用.方法 选择MHD患者62例,分别应用SGA、MQSGA和MIS进行营养评估,同时测定人体测量学指标及各种生化指标.分别将SGA、MQSGA和MIS评分值与各种客观营养指标进行Pearson相关及多元线性回归分析.结果 SGA分别与年龄、TSF、MAC、MAMC、BUN、SCr、Alb、PA等指标相关(P＜0.05),MQSGA分别与年龄、TSF、MAC、MAMC、BUN、SCr、Alb、PA、Hb、nPCR等指标相关(P＜0.05),而MIS与年龄、TSF、MAC、MAMC、BUN、SCr、Alb、PA、Hb、TIBC、hs-CRP、nPCR等指标相关(P＜0.05).进一步多元回归显示,SGA、MQSGA、MIS 3种评估方法与营养指标呈明显相关(P＜0.05),以MIS与其相关性最为密切,复相关系数最大(r=0.763),其次为MQSGA(r=0.713),SGA相关性最小(r=0.704).结论 与SGA、MQSGA 2种营养评估方法相比,MIS作为一种定量营养评估方法,更能准确地评估MHD患者的营养状态.%Objective To compare the methods, including SGA, MQSGA and MIS, used for the evaluation of nutritional status in maintenance hemodialysis(MHD)patients. Methods The nutrition statuses of 62 patients with MHD were evaluated by SGA, MQSGA and MIS, respectively. The anthropometric measurements were performed. Pearson's correlation analysis and multiple linear regression analysis were utilized to assess the correlations among SGA, MQSGA, MIS and some other objective nutritional parameters. Results According to Pearson's relativity analysis, SGA was significantly correlated with age, TSF, MAC, MAMC, Alb, and PA(P < 0. 05 ). MQSGA was significantly correlated with age, TSF, MAC, MAMC, Alb, PA, Hb, and nPCR(P <0. 05 ). MIS was significantly correlated with age, TSF, MAC, MAMC, BUN, SCr, Alb, PA, Hb, nPCR, TIBC, and hs-CRP( P<0. 05 ). According to further multiple linear regression analysis, SGA, MQSGA and MIS were significantly correlated with those objective parameters(P < 0. 05 ), with highest multiple correlation coefficient of MIS(r = 0. 763 ), Mowed by MQSGA(r = 0. 713)and SGA(r = 0. 704 ). Conclusion As a quantitative evaluation method of malnutrition, MIS provides higher accuracy in reflection of nutritional status in MHD patients, comparing with SGA and MQSGA.