摘要
目的分析血清白蛋白（Alb）、总蛋白（TP）、体质量指数（BMI）、简易营养评价表（MNA）评分、握力等营养评价指标在评判维持性血液透析（MHD）患者营养状况时的诊断价值。方法选取126例持续血液透析3个月以上的患者，根据其血清Alb的测定结果分为营养正常组（A组）和营养不良组（B组），同时检测其血清TP、BMI、MNA评分、握力等指标，采用独立样本的t检验、Spearman相关分析、受试者工作特征曲线（ROC曲线）等方法分析各指标在两组间的差异、相关性以及在评价MHD患者营养状况时的诊断价值。结果A、B两组患者的年龄、性别、身高、体质量、透析龄的差异均无统计学意义（均P〉0．05），Alb、TP、BMI、MNA评分、握力的差异均有统计学意义（均P〈0．05）。另外，校正了年龄、性别、透析龄后，Alb、TP、BMI、MNA评分、握力问均具有相关性（均P〈0．05）。但是ROC曲线分析说明，BMI在评价MHD患者的营养不良时，诊断价值不高，ROC曲线下面积小于其他指标。结论在评价MHD患者营养不良时，Alb、TP、MNA评分和握力均具有较高的诊断价值，而BMI并非是一个好的指标。
Objective To evaluate the diagnostic value of serum albumin （Alb）, total protein （TP）, body mass index （BMI）, Mini Nutritional Assessment （MNA） and hand strength in the nutritional status in maintenance hemodialysis （MHD） patients. Methods A total of 126 MHD patients were included in this study who had been on MHD for at least 3 months. Depending on the levels of Alb, patients were divided into two groups ： normal nutrition group （group A） and malnutrition group （group B）. TP, BMI, MNA and hand strength were also detected at the same time. Independent samples t test, Spearman correlation analysis, ROC curve were used to analyze their difference between the two groups and evaluate their diagnostic value in nutritional status in MHD patients. Results Age, sex, height, weight and dialysis ages had no statistical significant difference （P 〉 0.05） between group A and group B, while Alb, TP, BMI, MNA and hand strength had statistical significant difference （P 〈 0.05） between two groups. After adjusting for age, sex and hemodialysis age, Alb, TP, BMI, MNA and hand strength were positively correlated with each other （P 〈 0.05）. Since the area under the ROC curve of BMI was the smallest, BMI had the lowest diagnostic value in evaluation of the nutritional status in those patients. Conclusions Alb, TP, MNA and hand strength are good indexes in evaluation of the nutritional status in MHD patients but BMI is not.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2014年第2期119-122,共4页
Chinese Journal of Nephrology
