摘要
目的:比较不同营养评估法对老年维持性血液透析(MHD)患者死亡的预测作用。方法:纳入2010年6月前已行MHD>3月,年龄≥60岁的患者60例,收集一般资料,对其进行问卷调查,体测量及生化指标检测,分别计算主观全面营养评估(SGA)、营养不良—炎症评分(MIS)及微型营养评估简表(MNA-SF)评分。前瞻性随访至2013年6月,以患者死亡或试验结束为研究终点。Kaplan-meier法及COX回归分析不同营养评估方法对患者死亡的预测作用。结果:Kaplan-meier生存分析提示,分别以SGA及MNA-SF分组,营养不良患者组死亡率均明显高于营养良好组患者(P=0.008,P=0.029);而以MIS分组,两组患者死亡率无明显差异。COX回归分析提示校正年龄、尿素清除指数、合并心血管疾病、血磷、甲状旁腺激素及钙化等因素后,SGA评分结果对患者死亡有独立的预测作用(OR=8.877,P=0.045),但MNA-SF评分结果与患者死亡无独立相关性。结论:SGA评分法对老年MHD患者死亡的预测作用优于MIS及MNA-SF,更合适MHD患者整体营养的评估。
Objective：To compare the predictive ability of the different methods of nutritional assessment on the mortality of elderly hemodialysis patients. Methodology：Sixty patients, who were treated with MHD for more than 3 months at Jun 2010 and aged ≥60 years,were included in this study. SGA, MIS and MNA were used to assess the nutrition in the elderly patients with MHD. They were divided into malnutrition and good nutrition group according to the SGA or MNA-SF and followed up for 36 months. Death or end of the trail was the endpoint of study. Kaplan-Meier and Cox proportional hazard regressions were used to determine the predictive ability of the three methods of nutritional assessment on the mortality of the patients. Results： Kaplan-meier survival analysis showed that the mortality in the malnutrition group was higher than that in the good nutrition group. When grouping was done according to the MIS, there was no different in mortality between malnutrition and good nutrition group. COX regression analysis adjusted for age, kt/v, cardiovascular disease, phosphorus, PTH and calcifacation and other factors, result of SGA was the independent predictor of the death of the patients （OR= 8. 877,P= 0. 045）. But result of MNA-SF had no independent correlation with the death of patients. Conclusion：The predictive ability of SGA on the mortality of the elderly MHD patients is precede of the MIS and the MNA-SF. SGA as overall nutritional assessment method may be more appropriate for elderly MHD patients nutritional assessment.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2014年第1期36-41,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
维持性血液透析
营养评估
死亡
maintenance hemodialysis nutrition assessment mortality
