Svarstad E, Willassen Y, Iversen B M, Hordvik M
Medisinsk avdeling, Haukeland sykehus, Bergen.
Tidsskr Nor Laegeforen. 1993 May 20;113(13):1592-4.
Malnutrition, shown by fat depletion and muscle wasting, is common in uremia. The methods used to describe body composition in uremia are controversial. We have used ultrasonography of the thigh to evaluate fat and muscle in haemodialysis patients (group 1) (n = 14), peritoneal dialysis patients (group 2) (n = 10) and normal controls (group 3) (n = 13). Musculus rectus femoris diameter (0.84 +/- 0.06 cm versus 1.15 +/- 0.08 cm, p < 0.05) and cross sectional area (3.0 +/- 0.4 cm2 versus 5.5 +/- 0.4 cm2, p < 0.01) were significantly reduced in group 1 compared with group 3, as was also muscle area in group 2 (3.9 +/- 0.6, p < 0.05), indicating malnutrition in the dialysis patients. Peritoneal dialysis patients tended to have more subcutaneous fat (p = 0.07) and a larger musculus rectus diameter (p = 0.09) than haemodialysis patients, possibly reflecting better preserved nutritional status. Ultrasonography was equal to computed tomography for estimating these parameters. Ultrasonography is a useful tool for evaluating body composition in uremia, and has a capacity for detection of malnutrition, and possibly for early discrimination between patient groups with different dialysis modalities.
以脂肪消耗和肌肉萎缩为表现的营养不良在尿毒症患者中很常见。用于描述尿毒症患者身体组成的方法存在争议。我们采用大腿超声检查来评估血液透析患者（第1组）（n = 14）、腹膜透析患者（第2组）（n = 10）和正常对照组（第3组）（n = 13）的脂肪和肌肉情况。与第3组相比，第1组的股直肌直径（0.84±0.06 cm对1.15±0.08 cm，p<0.05）和横截面积（3.0±0.4 cm²对5.5±0.4 cm²，p<0.01）显著减小，第2组的肌肉面积（3.9±0.6，p<0.05）也减小，提示透析患者存在营养不良。腹膜透析患者的皮下脂肪往往比血液透析患者更多（p = 0.07），股直肌直径更大（p = 0.09），这可能反映出其营养状况保存得更好。在评估这些参数方面，超声检查与计算机断层扫描效果相当。超声检查是评估尿毒症患者身体组成的有用工具，具有检测营养不良的能力，还可能有助于早期区分不同透析方式的患者群体。
