本文關(guān)鍵詞： 腹膜透析 蛋白能量消耗 血鈉濃度 SGA　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討腹膜透析(PD)患者血清鈉濃度與蛋白-能量消耗(PEW)的關(guān)系,為臨床干預(yù)提供理論依據(jù)。方法:選擇2015年6月-2016年12月于山西醫(yī)科大學(xué)第一附屬醫(yī)院腎內(nèi)科行PD患者共108例,符合入選標準88例。獲取患者的基本情況包括[基礎(chǔ)原發(fā)病因、性別、年齡、體重、身高、體重指數(shù)(BMI)、血壓水平、透析齡],采用標準的技術(shù)檢測患者的各項身體指標包括[上臂圍(AC)、肱三頭肌皮褶厚度(TSF)和上臂肌圍(AMC)]等,檢測生化指標包括[血清白蛋白(ALB)、血清前白蛋白(PLB)、血紅蛋白(Hb)、紅細胞壓積(MCV)、血轉(zhuǎn)鐵蛋白(TF)、血總膽固醇(TC)、血甘油三酯(TG)、血肌酐(SCr)血超敏C反應(yīng)蛋白(hs-CRP)、血清鉀離子(K)、血鈣(Ca)、血鈉(Na)]等,及采取主觀的綜合性評估法(SGA)評測患者的營養(yǎng)狀況。根據(jù)ISRMN的診斷標準并計算患者的PEW患病率,根據(jù)入組患者血鈉濃度的均值分為A組(血Na137mmol/L)和B組(血Na"g137mmol/L),應(yīng)用統(tǒng)計學(xué)方法分別比較兩組上述指標及PEW的患病率的差異,并用pearson法分析PD患者PEW的一些指標與血鈉濃度的相關(guān)性。結(jié)果:1.男性48例,女性40例,年齡20~78歲,平均(49.6±13.93)歲,透析時間3~64月,平均透析齡(16.25±13.57)月,糖尿病患者24例,占(27.3%);2.我院PEW患病率為39.7%;3.兩組的性別、年齡、BMI、透析齡、血壓、TSF、PLB、Hb、MCV、TF、TC、TG、SCr、K、Ca、、hs-CRP差異均無統(tǒng)計學(xué)意義(P0.05);4.與B組相比,A組上臂圍、上臂肌圍、血清白蛋白水平偏低,SGA評分偏高,差異有統(tǒng)計學(xué)意義(P0.01);5.PD患者血鈉濃度與上臂圍、上臂肌圍、血清白蛋白呈正相關(guān)(P0.01),與SGA呈負相關(guān)(P0.01)。結(jié)論:PD患者PEW發(fā)生率較高,且PEW的相關(guān)指標與血清鈉濃度具有一定的相關(guān)性,提示預(yù)防PD患者的低鈉水平,可在一定程度上減少PEW的發(fā)生,改善患者預(yù)后,延長生命。
[Abstract]:Objective: to investigate the relationship between serum sodium concentration and protein / energy consumption (PEW) in patients with peritoneal dialysis (PDD). Methods: a total of 108 PD patients were selected from June 2015 to December 2016 in the Department of Renal Medicine, the first affiliated Hospital of Shanxi Medical University. Meet the inclusion criteria in 88 cases. Basic information obtained from the patient includes. [Basic primary causes, sex, age, weight, height, body mass index (BMI), blood pressure level, dialysis age]. [The upper arm circumference, triceps skinfold thickness (TSF), and upper arm muscle circumference (AMC), etc. [Serum albumin (ALB), serum prealbumin (PLB), hemoglobin (HB), hematocrit (MCV), transferrin (TFN), serum total cholesterol (TC). Serum triglyceride (TGG), serum creatinine (SCR), serum hypersensitive C-reactive protein (hs-CRPN), serum potassium ion (KG), serum calcium (Cam), blood sodium (Na), etc. The nutritional status of the patients was evaluated by the subjective comprehensive evaluation method (SGA). The prevalence of PEW was calculated according to the diagnostic criteria of ISRMN. The patients were divided into two groups: group A (Na 137 mmol / L) and group B (Na "g 137 mmol / L). Statistical methods were used to compare the two groups of the above indicators and the prevalence of PEW differences. The correlation between PEW and serum sodium concentration in PD patients was analyzed by pearson method. Results: 1. There were 48 males and 40 females aged 20 to 78 years. The mean age of dialysis was 49.6 鹵13.93 years, the dialysis time was 3 ~ 64 months, and the average dialysis age was 16.25 鹵13.57 months. There were 24 cases of diabetes mellitus, accounting for 27.3%. 2. The prevalence of PEW in our hospital was 39.7; 3. Sex, age, age, age of dialysis, blood pressure of TSF, PLB, MCV, TFT, TGN, TGG, and Ke Ke Ca. of the two groups. The results showed that the blood pressure of the two groups was higher than that of the control group. There was no significant difference in hs-CRP between the two groups (P 0.05). 4.Compared with group B, the upper arm circumference, upper arm muscle circumference and serum albumin level in group A were lower than those in group B, and the SGA scores were higher than those in group B (P 0.01). 5. Serum sodium concentration was positively correlated with upper arm circumference, upper arm muscle circumference and serum albumin, and negatively correlated with SGA (P 0.01). Conclusion the incidence of PEW is higher in patients with 7% PD. The correlation between PEW and serum sodium concentration suggested that the prevention of hyponatremia in PD patients could reduce the occurrence of PEW to a certain extent, improve the prognosis and prolong the life of PD patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5

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