持续非卧床腹膜透析患者年龄与营养状况评价

【】　目的　探索持续非卧床腹膜透析（CAPD）患者年龄与营养状况的关系，为营养教育提供指导。　方法　对2007年8月-2010年1月腹膜透析177例患者的临床资料进行回顾性分析，包括血红蛋白（HGB）、血清白蛋白（ALB）、年龄、体重指数（BMI）、腹膜平衡试验（PET）、尿素清除指数（Kt/V）、24h尿蛋白、腹透液漏出蛋白、标准化每日蛋白质分解率（nPCR）等，分析年龄与营养状况的关系。　结果　老年组（≥60岁）和中青年组（<60岁）ALB分别为（31.54±5.91）、（33.24±4.75）g/L，老年组ALB较低（P<0.05）；老年组Kt/V值1.95±0.63和HGB水平（95.25±22.89）g/L均高于青年组（P<0.05）。两组患者营养不良与BMI、PET、每日蛋白漏出总量、nPCR无关。　结论　CAPD老年患者（≥60岁）更容易发生营养不良，且老年组低蛋白血症与透析充分性无明显关系。故应加强老年CAPD患者的饮食营养管理指导，设计合理的饮食。【Abstract】　Objective　Toinvestigatetherelationshipbetweenageandnutritionstatusofthepatientsundergoingcontinuousambulatoryperitonealdialysis(CAPD),andprovideinstructionsfornutritioneducation.　Methods　Weretrospectivelyanalyzedtheclinicaldataof177patientshavingundergoneCAPDintheDepartmentofNephrologyofWestChinaHospitalbetweenApril2007andJanuary2010.Clinicalparameterscollectedincludedhemoglobin(HGB),serumalbumin(ALB),age,bodymassindex(BMI),resultsoftheperitonealequilibriumtest(PET),ureaclearanceindex(Kt/V),24-hoururinaryprotein,proteinlossintheperitonealdialysate,normalizedproteincatabolicrate(nPCR).Relationshipbetweenageandnutritionstatusinthesepatientswereanalyzed.　Results　Plasmaalbuminwas(31.54±5.91)g/Land(33.24±4.75)g/Lrespectivelyinpatientsoforolderthan60yearsold(theelderlygroup)andinpatientsyoungerthan60yearsold(theyoungergroup).Comparedwiththeyoungergroup,patientsintheelderlygrouphadlowerALB(P<0.05),buthigherKt/V1.95±0.63andhemoglobinlevel(95.25±22.89)g/L(P<0.05).Inaddition,malnutritioninbothgroupswasnotassociatedwithBMI,PETresults,dailyproteinlossintheperitonealdialysateornPCR.　Conclusions　Patientsoforolderthan60yearsoldundergoingCAPDaremorelikelytodevelopmalnutrition,indicatingthathypoalbuminemiaisnotassociatedwithdialysisinadequacy.WeadvocateenhancingdietnutritioneducationinelderlyCAPDpatientsandprovidingthemwithbalanceddietregime.