运用患者主观全面评定法对维持性血液透析患者蛋白能量消耗状态的调查及可干预危险因素分析

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Abstract Objective To investigate the protein energy wasting(PEW)status of patients with maintenance hemodialysis(MHD)by patient-generated subjective global assessment(PG-SGA)and analyze the interventionable risk factors.Methods From September to December 2018,432 patients with MHD were selected as research objects from four dialysis centers of Affiliated Hospital of Weifang Medical University,Weifang Yidu Central Hospital,Weicheng Economic Development Zone Hospital,People′s Hospital of Xiashan Ecological and Economic Development Zone of Weifang City.A cross-sectional study was conducted.The PG-SGA combined with questionnaires,anthropometry and biochemical indicators were used to evaluate PEW status and analyze influencing factors in MHD patients.Results The total incidence rate of PEW in 432 patients with MHD was 52.78%.The total incidence rates of PEW in patients with diabetes,acidosis,inadequate dialysis Kt/V＜1.2,age≥65 years,and dialysis time≥5 years were higher than those in non-diabetes,non-acidosis,adequate dialysis,age＜65 years,and dialysis time＜5 years patients,the differences were statistically significant(P＜0.05).In different PG-SGA qualitative evaluation,individual nutritional indicators such as bodymass index(BMI),upper arm midpoint circumference(MAC),triceps skin fold thickness(TSF),upper arm muscle circumference(MAMC),albumin(ALB),and hemoglobin(Hb),PG-SGA C was lower than PG-SGA A and PG-SGA B,and PG-SGA B was lower than PG-SGA A,with statistically significant differences(P＜0.05).Logistic multivariate analysis showed that diabetes(OR=3.01,95%CI:1.52-5.84),acidosis(OR=1.92,95%CI:1.13-3.34),inadequate dialysis Kt/V＜1.2(OR=1.73,95%CI:1.05-3.68)were all interventionable risk factors for PEW in MHD patients(P＜0.05).Conclusion The incidence of PEW is high in MHD patients,especially in patients with diabetes.Diabetes,acidosis and inadequate dialysis Kt/V＜1.2 are interventionable risk factors for PEW in MHD patients.

Key words： Maintenance hemodialysis Protein energy wasting Patient-generated subjective global assessment Interventionable risk factors

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	Articles by authors
	CHEN Xue-xun
	ZHU Zi-hao
	LIU Zhi-min
	ZHANG Cheng-yin
	ZHANG Hai-bo
	ZHAO Xue-lan
	Xu Hui-yin
	LI Xuan
	CAO Bo
	CHAI Chun-xiang
	GUO min
	WU Wen-bin

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CHEN Xue-xun,ZHU Zi-hao,LIU Zhi-min, et al. Investigation and interventionable risk factors analysis of protein energy wasting status in maintenance hemodialysis patients by patient-generated subjective global assessment[J]. 中国当代医药, 2020, 27(9): 149-152.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I9/149

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