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目的探讨慢性肾脏病(CKD)患儿的营养状况及发生营养不良的影响因素。方法以2002年美国国家肾脏病基金会制定的诊断标准,以2012年9月至2015年10月在周口永兴医院确诊为CKD的患儿为研究对象,对其身长、体质量等参数进行测量;采用WHO通用的Z值评分标准,对CKD患儿营养状况进行分析,并对研究对象的家长进行营养相关知识调查,对CKD患儿营养不良发生情况进行描述,并对营养不良发生影响因素进行分析。结果共纳入研究CKD患儿1 500例,年龄3~14岁,平均年龄为(8.7±3.5)岁,男、女分别为810、690例,男女性别比为1.17∶1。CKD病程平均(2.8±1.3)年,CKD分期为Ⅰ、Ⅱ、Ⅲ、Ⅳ期者分别有375、420、300、405例。共有878例CKD患儿出现营养不良,营养不良发生率为58.5%,其中生长迟缓230例、低体质量182例、消瘦466例。多因素分析结果显示,CKD患儿病程越长、分期越高,发生营养不良的可能性越大(OR=1.773、OR=1.598)。CKD患儿父母了解营养不良知识、接受过营养知识指导、知道营养素的概念、儿童进行过营养状况检查、关注儿童的饮食情况的调查对象发生营养不良的可能性较低(OR=0.598、0.472、0.603、0.617、0.392)。结论 CKD患儿营养不良发生率高,CKD分期越高、病程越长患儿发生营养不良的风险越高,家长多了解营养不良知识有助于降低患儿营养不良的发生率。
Objective To investigate the nutritional status of children with chronic kidney disease (CKD) and the influencing factors of malnutrition. Methods Based on the diagnostic criteria developed by the National Kidney Foundation in 2002, the children diagnosed as CKD at Yongxing Hospital in Zhoukou from September 2012 to October 2015 were selected as the study objects to measure their body length, body weight and other parameters ; Using the WHO Z-score standard for nutritional status analysis of children with CKD, and parents of nutritional status of the survey of knowledge about the incidence of malnutrition in children with CKD described, and the impact of malnutrition factors were analysis. Results A total of 1 500 children with CKD were enrolled in this study. The mean age was (8.7 ± 3.5) years. The male and female were 810,690 and the sex ratio was 1.17:1. The average duration of CKD (2.8 ± 1.3) years, CKD staging Ⅰ, Ⅱ, Ⅲ, Ⅳ were 375,420,300,405 cases. A total of 878 cases of CKD children malnutrition, malnutrition incidence was 58.5%, of which 230 were slow growth, low body mass 182 cases, 466 cases of weight loss. Multivariate analysis showed that the longer the duration of CKD patients, the higher the stage, the greater the likelihood of malnutrition (OR = 1.773, OR = 1.598). Children with CKD had less knowledge of malnutrition, received guidance on nutritional knowledge, knew the concept of nutrients, checked the nutritional status of children, and investigated the children’s diet. The odds of having malnutrition were lower (OR = 0.598, 0.472, 0.603, 0.617, 0.392). Conclusions The incidence of malnutrition in children with CKD is high, and the higher the CKD stage, the longer the disease is. The higher the risk of malnutrition, the more knowledge of malnutrition can help reduce the incidence of malnutrition.