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主观全面评定是检测肾移植患者营养不良的一种有用方法。

Subjective global assessment is a useful method to detect malnutrition in renal transplant patients.

作者信息

Sezer S, Ozdemir F N, Afsar B, Colak T, Kizay U, Haberal M

机构信息

Department of Nephrology, Baskent University Hospital, Ankara, Turkey.

出版信息

Transplant Proc. 2006 Mar;38(2):517-20. doi: 10.1016/j.transproceed.2005.12.080.

Abstract

Adequate nutrition is essential for the well-being of renal transplant patients. While body weight gain is a common widely investigated finding, a considerable fraction of patients exhibit poor nutritional status after successful kidney transplantation. In the present study, the prevalence association with nutritional parameters and clinical data of malnutrition among kidney transplant patients were determined based upon a subjective global assessment. This cross-sectional study in the transplant outpatient clinic included 47 patients (10 women, 37 men) of mean age 37.6 +/- 10.2 years. The same dietitian performed the assessment on all patients, including anthropometric measurements of body mass index (BMI), mid-arm circumference, and triceps skinfold thickness. The patient data including medications, number of hospitalizations in the preceding year, and presence of chronic allograft failure were collected from medical records. The mean laboratory values during the last 6 months included hemoglobin, creatinine, albumin, phosphorus, C-reactive protein levels, and lipid profile. The patients were classified into 3 groups defined as A (n = 31, 66%), B (n = 11, 23.4%), and C (n = 5, 10.6%), namely, A, no malnutrition versus B/C, moderate or severe malnutrition. Comparison of the 2 groups revealed the serum albumin (P < .0001), body mass index (P = .02), and mid-arm circumference (P = .02) to be higher in group A than groups B/C. Group B/C patients showed higher levels of C-reactive protein (P < .0001). When compared to the pretransplantation period, the 31 patients in group A included 26 who had increased body mass index after transplantation versus only 3 of 16 patients in groups B/C had (P < .0001). The hospitalization rates were significantly lower in group A (P = .02). Additionally, the patients in group A tended to have a lower frequency of chronic allograft rejection when compared to group B/C subjects (P = .13). In conclusion, assessment of nutritional status of renal transplant patients combined with intervention in the nutritional intake may decrease the morbidity rates in this patient group.

摘要

充足的营养对肾移植患者的健康至关重要。虽然体重增加是一个常见且被广泛研究的现象,但相当一部分患者在肾移植成功后营养状况不佳。在本研究中,基于主观全面评定确定了肾移植患者营养不良与营养参数及临床数据之间的患病率关联。这项在移植门诊进行的横断面研究纳入了47例患者(10名女性,37名男性),平均年龄为37.6±10.2岁。同一名营养师对所有患者进行评估,包括人体测量指标如体重指数(BMI)、上臂中部周长和三头肌皮褶厚度。从病历中收集患者数据,包括用药情况、前一年的住院次数以及慢性移植肾失功情况。过去6个月的平均实验室值包括血红蛋白、肌酐、白蛋白、磷、C反应蛋白水平和血脂谱。患者被分为3组,即A组(n = 31,66%)、B组(n = 11,23.4%)和C组(n = 5,10.6%),A组为无营养不良,B/C组为中度或重度营养不良。两组比较显示,A组的血清白蛋白(P <.0001)、体重指数(P =.02)和上臂中部周长(P =.02)高于B/C组。B/C组患者的C反应蛋白水平更高(P <.0001)。与移植前相比,A组的31例患者中有26例移植后体重指数增加,而B/C组的16例患者中只有3例(P <.0001)。A组的住院率显著更低(P =.02)。此外,与B/C组患者相比,A组患者慢性移植肾排斥反应的发生率往往更低(P =.13)。总之,评估肾移植患者的营养状况并对营养摄入进行干预可能会降低该患者群体的发病率。

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