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目的分析维持性血液透析患者营养状况及发生营养不良的危险因素,为营养干预提供依据。方法对98例患者进行3 d内的24 h膳食调查及改良定量主观营养评估(MQSGA),并进行必要的人体学测量及生化指标的测定。结果膳食调查结果显示,实际标准体质量每日能量摄入量(DEI)为(117.15±5.98)kJ/(kg.d)、每日蛋白质摄入量(DPI)为(1.02±0.42)g/(kg.d),优质蛋白质的摄入量为(19.8±12.9)g/d。患者的DPI、DEI及优质蛋白质的摄入量均低于推荐标准。营养评估结果显示营养不良患者比例占48.9%。透析充分患者较透析不充分患者营养不良发生率低,组间差异有统计学意义(P<0.05)。60岁及以上老年患者营养不良发生率明显高于60岁以下患者(P<0.05)。结论维持性血液透析患者营养不良发生比例较高,主要与透析不充分、蛋白质及能量摄入不足、年龄等因素有关。
Objective To analyze the nutritional status of patients with maintenance hemodialysis and the risk factors of malnutrition, and provide basis for nutrition intervention. Methods A total of 98 patients underwent a 24-hour diet survey and modified Quantitative Subjective Nutrition Assessment (MQSGA) within 3 days, and the necessary anthropometric measures and biochemical indicators were determined. Results The results of dietary survey showed that daily DEI was (117.15 ± 5.98) kJ / (kg · d) and daily protein intake (DPI) was (1.02 ± 0.42) g / (kg.d), and high-quality protein intake (19.8 ± 12.9) g / d. The patient’s DPI, DEI and high-quality protein intake were lower than the recommended standard. Nutritional assessment showed that malnutrition accounted for 48.9% of patients. Patients with adequate dialysis were less malnourished than those with inadequate dialysis, with significant differences between groups (P <0.05). The incidence of malnutrition in elderly patients 60 years and older was significantly higher than that in patients under 60 (P <0.05). Conclusions Patients with maintenance hemodialysis have a higher incidence of malnutrition, mainly related to inadequate dialysis, inadequate protein and energy intake, and age.