Application of bioelectrical impedance analysis in nutritional assessment of patients with hemodialysis
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摘要: 目的 探讨基于生物电阻抗法(BIA)的人体成分测量评估维持性血液透析(MHD)患者营养状况的效果及相关影响因素。 方法 选择54例维持性血液透析患者作为研究对象,应用BIA、人体测量指标、实验室指标检测结果评估患者的营养状况,采用多元线性回归分析MHD患者骨骼肌减少的相关影响因素。 结果 BIA检测结果显示,本组患者骨骼肌不足的发生率为40.74%, 检出率较高; Pearson相关分析显示,骨骼肌与体质量指数、高密度脂蛋白、转铁蛋白、血清磷以及身体细胞量、骨矿物质含量、基础代谢、上臂肌围、上臂围、体脂肪百分比、蛋白质、无机盐等均具有显著相关性(P<0.05); 多元线性回归分析显示,血清磷与蛋白质为骨骼肌的影响因素(P<0.05)。 结论 MHD患者营养不良发生率较高,骨骼肌减少问题突出,血清磷、蛋白质水平是MHD患者骨骼肌含量的影响因素。因此,临床应加强对患者血清磷水平的控制,以减缓骨骼肌萎缩进程,并推荐将BIA技术联合实验室指标检测用于MHD患者营养状况的综合评估与定期随访中。Abstract: Objective To explore the effect and related influencing factors of body composition measurement based on bioelectrical impedance analysis(BIA)in evaluating the nutritional status of patients with maintenance hemodialysis(MHD). Methods A total of 54 patients with MHD were selected as research objects. The nutritional status of MHD patients was evaluated by BIA, anthropometric indexes and laboratory indexes. The related influencing factors of skeletal muscle loss in MHD patients were analyzed by multiple linear regression analysis. Results The results of BIA showed that the incidence of skeletal muscle deficiency was 40.74%, and the detection rate was high. Pearson correlation analysis showed that skeletal muscle was significantly correlated with body mass index, high-density lipoprotein, transferrin, serum phosphorus, body cell volume, bone mineral content, basic metabolism, upper arm muscle circumference, upper arm circumference, body fat percentage, protein and inorganic salt(P<0.05). Multiple linear regression analysis showed that serum phosphorus and protein were the influencing factors of skeletal muscle(P<0.05). Conclusion The incidence of malnutrition in MHD patients is high, and the problem of skeletal muscle reduction is prominent. Serum phosphorus and protein levels are the influencing factors of skeletal muscle content in MHD patients. It is necessary to strengthen the control of serum phosphorus level in patients with MHD in order to slow down the process of skeletal muscle atrophy. BIA technology combined with laboratory index detection is recommended for comprehensive evaluation and regular follow-up of nutritional status of MHD patients.
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