个体化营养干预对维持性血液透析患者肌少症及生存质量的影响

Effects of individualized nutrition intervention on sarcopenia and quality of life in maintenance hemodialysis patients

  • 摘要:
    目的 探讨个体化营养干预对维持性血液透析(MHD)患者肌少症及生存质量的影响。
    方法 选取行规律血液透析治疗≥6个月的102例患者作为研究对象,收集一般资料,检测血生化指标,并测量骨骼肌质量指数、握力和日常步速。根据亚洲肌少症工作组的肌少症诊断标准,将患者分为无肌少症组(n=74)和肌少症组(n=28),均给予个体化营养干预治疗3个月,比较2组患者的临床资料和治疗前后肌少症相关指标(骨骼肌质量指数、握力、日常步速)、生存质量(SF-36量表评分)。
    结果 102例患者肌少症发生率为27.45%(28/102);2组患者的年龄、性别、体质量指数、血清白蛋白、超敏C反应蛋白、血尿素氮、血肌酐比较,差异有统计学意义(P < 0.05)。治疗前,肌少症组患者的生理机能、躯体疼痛、一般健康状况维度评分和生理健康领域总分、SF-36量表总分均低于无肌少症组,差异有统计学意义(P < 0.05)。治疗后, 2组患者骨骼肌质量指数、握力均大于治疗前,且肌少症组骨骼肌质量指数、握力的治疗前后差值大于非肌少症组,差异有统计学意义(P < 0.05);2组患者治疗前后日常步速比较,差异无统计学意义(P>0.05)。治疗后, MHD患者的生理职能、一般健康状况、精力维度评分和生理健康领域总分、SF-36量表总分均高于治疗前,差异有统计学意义(P < 0.05)。
    结论 MHD患者肌少症发病率较高,与年龄、性别、营养状态、微炎症有关,严重影响患者的生存质量。个体化营养干预治疗可有效减轻MHD患者的肌少症症状,并提高患者的生存质量。

     

    Abstract:
    Objective To explore effects of individualized nutrition intervention on sarcopenia and quality of life in maintenance hemodialysis(MHD)patients.
    Methods A total of 102 patients who received regular hemodialysis for more than 6 months were selected as research objects, and their general data were collected, biochemical indexes were detected, and skeletal muscle mass index, grip strength and daily walking speed were measured. According to the diagnostic criteria of Asian Sarcopenia Working Group (AWGS), the objects were divided into sarcopenia-free group(n=74) and sarcopenia group(n=28). Patients in both groups were given individualized nutritional intervention for 3 months, and the changes of sarcopenia and quality of life before and after treatment were compared. The clinical data and related indicators of sarcopenia (skeletal muscle mass index, grip strength, daily walking speed) and quality of life36-item Shot-form Health Status Survey(SF-36)score of the two groups were compared before and after treatment.
    Results Among 102 subjects, the incidence of sarcopenia was 27.45%(28/102), and there were statistical differences in age, sex, body mass index, serum albumin, hypersensitive C-reactive protein, blood urea nitrogen, blood creatinine between the two groups (P < 0.05). Before treatment, the physiological function, body pain, general health dimension score, total score in physical health field and total score of SF-36 Scale in the sarcopenia group were lower than those of the sarcopenia-free group (P < 0.05). After treatment, the skeletal muscle mass indexes and grip strength of two groups were higher than before treatment, and skeletal muscle mass indexes and the difference value of grip strength before and after treatment of the sarcopenia group were greater than those of sarcopenia-free group (P < 0.05). There was no significant difference in daily walking speed between two groups before and after treatment (P>0.05). After treatment, the physiological function, general health status, energy dimension score, total score of physiological health field and total score of SF-36 Scale of MHD patients were higher than before treatment (P < 0.05).
    Conclusion The prevalence of sarcopenia in MHD patients is high, which is related to age, gender, nutritional status and microinflammation, and seriously affects the quality of life of patients. Individualized nutritional intervention therapy can effectively relieve the sarcopenia and improve the quality of life of patients.

     

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