拉瓦尔品第军事医院肾内科稳定的慢性血液透析患者的营养状况和炎症状态

Nutritional profile and inflammatory status of stable chronic hemodialysis patients at Nephrology Department, Military Hospital Rawalpindi.

作者信息

Siddiqui Umair Ahmed, Halim Abdul, Hussain Tassawar

机构信息

Department of Nephrology, Military Hospital, Rawalpindi.

出版信息

J Ayub Med Coll Abbottabad. 2007 Oct-Dec;19(4):29-31.

PMID:18693592

Abstract

BACKGROUND

Protein-energy malnutrition (PEM) is common in the haemodialysis population. Identification and management of these patients can result in significant reduction in morbidity and mortality. Aim of the study was to find the prevalence of PEM in otherwise stable haemodialysis patients at Military Hospital Rawalpindi at a single point in time with the help of established biochemical and physical markers.

MATERIAL AND METHODS

Height, dry weight and body mass index (BMI) were recorded for 64, stable, 14-75 year-old patients who were on haemodialysis for > or = 3 months. Blood samples were drawn (pre-dialysis) for complete blood count, serum C-reactive protein, serum total protein, serum albumin and serum Creatinine. Ideal body weights and BMI were obtained from Pakistan Army Selection and Recruitment standards.

RESULTS

Out of 64 patients 43 (67%) were males. Mean age was 44.5 +/- 14.3 yr. Mean haemoglobin was 8.84 +/- 2 g/dl. Fifty-seven patients (89%) had haemoglobin < or = 11 g/dl. Pearson correlation coefficient (r) with albumin was significant (p = 0.01). The mean serum albumin was 34.2 +/- 4.25 g/l. Serum albumin of less than 40 g/l in 58 patients (90.6%). C-Reactive protein was available for 58 (90.6%) of patients. It was positive in 23 (35.9%) and was associated with a lower mean serum albumin (32.7 g/l vs 35.4 g/l) which was statistically significant (p = 0.017). There was no significant relationship between the lymphocyte count and albumin levels. However, the Pearson correlation of albumin with the total WBC count gave ap value of 0.05. Mean BMI was 19.8 +/- 2.9 kg/m2. Thirty-seven (57.8%) patients had BMI in the normal range (18.5-24.6 kg/m2) and 24 (37.5%) were below normal (14.6-18.3 kg/m2). Correlation of albumin with BMI and serum creatinine was not significant (p = 0.46 and 0.53 respectively).

CONCLUSION

Serum albumin is a strong marker of malnutrition but needs to be associated with other physical and inflammatory parameters to correctly identify malnourished haemodialysis patients.

摘要

背景

蛋白质 - 能量营养不良（PEM）在血液透析人群中很常见。对这些患者的识别和管理可显著降低发病率和死亡率。本研究的目的是借助既定的生化和身体指标，在某一时刻找出拉瓦尔品第军事医院病情稳定的血液透析患者中PEM的患病率。

材料与方法

记录了64名年龄在14 - 75岁、病情稳定且接受血液透析≥3个月的患者的身高、干体重和体重指数（BMI）。采集（透析前）血样进行全血细胞计数、血清C反应蛋白、血清总蛋白、血清白蛋白和血清肌酐检测。理想体重和BMI取自巴基斯坦陆军选拔与招募标准。

结果

64名患者中43名（67%）为男性。平均年龄为44.5±14.3岁。平均血红蛋白为8.84±2 g/dl。57名患者（89%）的血红蛋白≤11 g/dl。与白蛋白的Pearson相关系数（r）具有显著性（p = 0.01）。平均血清白蛋白为34.2±4.25 g/l。58名患者（90.6%）的血清白蛋白低于40 g/l。58名（90.6%）患者检测了C反应蛋白。其中23名（35.9%）呈阳性，且与较低的平均血清白蛋白相关（32.7 g/l对35.4 g/l）有统计学显著性（p = 0.017）。淋巴细胞计数与白蛋白水平之间无显著关系。然而，白蛋白与白细胞总数的Pearson相关性p值为0.05。平均BMI为19.8±2.9 kg/m²。37名（57.8%）患者的BMI在正常范围（18.5 - 24.6 kg/m²），24名（37.5%）低于正常范围（14.6 - 18.3 kg/m²）。白蛋白与BMI和血清肌酐的相关性不显著（分别为p = 0.46和0.53）。