| 引用本文: | 刘楠,梁海琴,钟晓丽,王慧,陈沾,王蕊,邱丽君,李雪.相位角在海南地区血液透析患者营养评估中的应用研究[J].中国临床新医学,0,():-. |
| liunan.相位角在海南地区血液透析患者营养评估中的应用研究[J].中国临床新医学,0,():-. |
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| 摘要: |
| 目的 探讨50kHz相位角(PA)在评估血液透析患者营养不良中的作用。方法 选择2019年1月至2020年 12月在海南医学院第一附属医院血液净化中心规律进行血液透析（HD）治疗的98例血液透析患者，进行营养不良-炎症评分(MIS)及相位角测量。以MIS为诊断营养不良金标准，绘制受试者工作特征曲线(ROC)对相位角进行诊断一致性评价。通过 Spearman双变量线性相关检验分析HD患者PA与体重、上臂肌围(AMC)、血白蛋白、前白蛋白、血清总铁结合力、转铁蛋白等临床参数的相关性。结果 HD患者的营养不良发生率为90.82%； PA (50 kHz)评估无-轻度营养不良、轻-中度营养不良、中-重度营养不良的ROC曲线下面积(AUC)分别为0.902、0.665、0.702，敏感性分别为85.29%、80.00%、90.00%，特异性分别为88.89%、73.53%、57.78%；PA 临界值分别为5.25°、4.65°、3.82°；HD患者的PA与年龄呈负相关(P<0.05)，与体重、上臂肌围、白蛋白、前白蛋白、血清总铁结合力、转铁蛋白呈正相关(P<0.05)。结论 终末期肾脏病血液透析患者营养不良发生率很高；PA与MIS评估HD患者营养不良有良好的一致性；血液透析患者的PA与体重、上臂肌围、白蛋白、前白蛋白、血清总铁结合力、转铁蛋白呈正相关，能敏感、准确的反应患者的营养状况，可用于临床HD患者营养评估。 |
| 关键词: 相位角 血液透析 营养不良-炎症评分 营养评估 诊断一致性 |
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| 基金项目:海南省卫生计生行业科研项目(编号：19A200016) |
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| Application of phase angle in nutritional evaluation of hemodialysis patients in Hainan |
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liunan
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the First Affiliated Hospital of Hainan Medical University
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| Abstract: |
| Objective：To evaluate the application value of phase angle (PA) in nutritional assessment of hemodialysis patients. Methods：A total of 98 hemodialysis patients were selected from the Department of Nephrology, the First Affiliated Hospital of Hainan Medical University from January 2019 to December 2020. Malnutrition inflammation score (MIS) and phase angle were measured. Taking MIS as the gold standard for malnutrition diagno- sis, the receiver operating characteristic curve (ROC) was drawn to evaluate the consistency of diagnosis. The correlation between PA and weight, upper arm muscle cir- cumference (AMC) and other clinical parameters was analyzed by Spearman bivariate linear correlation test. Results： The incidence of malnutrition in HD was 90.82%; the area under ROC curve (AUC) of no mild malnutrition、 mild to moderate malnutrition 、and moderate to severe malnutrition evaluated by PA (50 kHz) were 0.902、0.665 and 0.702 respectively, the sensitivity were 85.29%、80.00% and 90.00% respectively, the specificity were 88.89%、73.53% and 57.78% respectively, and the critical value of PA were 5.25° 、4.65°and 3.82° respectively. PA was negatively correlated with age (P<0.05), and positively correlated with weight, AMC, albumin, prealbumin, total iron binding capacity and transferrin (P<0.05). Conclusion： The incidence of malnutrition is high in hemodialysis patients with endstage renal disease; PA and MIS had good agreement in assessing malnutrition in HD patients; PA was positively correlated with weight, AMC, albumin, prealbumin, total iron binding capacity and transferrin, which can be used for malnutrition assessment. |
| Key words: Phase angle (PA) Hemodialysis Malnutrition inflammation score Nutritional assessment Diagnostic consistency |
