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中华养生保健 ›› 2025, Vol. 43 ›› Issue (7): 76-79.

• 临床研究 • 上一篇    下一篇

生物电阻抗法评估维持性血液透析患者人体成分的纵向变化

许明1, 高源华2, 矫春晓1, 曲少琴2, 孙晓燕2, 李海强1   

  1. 1.烟台业达医院营养科,山东 烟台,264006;
    2.烟台业达医院血液净化科,山东 烟台,264006
  • 出版日期:2025-04-01 发布日期:2025-04-02
  • 作者简介:许明(1981—),女,汉族,籍贯:黑龙江省绥化市,本科,主管护师,研究方向:血液透析患者的营养管理。

Longitudinal Changes in Body Composition of Patients Undergoing Maintenance Hemodialysis Assessed by BIA

XU Ming1, GAO Yuan-hua2, JIAO Chun-xiao1, QU Shao-qin2, SUN Xiao-yan2, LI Hai-qiang1   

  1. 1. Department of Nutrition, Yantai Yeda Hospital, Yantai Shandong 264006, China;
    2. Department of Blood Purification, Yantai Yeda Hospital, Yantai Shandong 264006, China
  • Online:2025-04-01 Published:2025-04-02

摘要: 目的 利用生物电阻抗法评估维持性血液透析患者1年前后人体成分的纵向变化。方法 选取2020年1月1日—2023年2月28日在烟台业达医院行规律血液透析的120例患者资料,其中男性61例,女性59例;年龄29~84岁,平均年龄(56.23±13.52)岁;≥60岁老年患者50例;患者间隔1年时间完成2次人体成分分析,收集人体成分分析数据以及对应月份的白蛋白、前白蛋白、肌酐、尿素等生化指标结果。采用自身前后对照的方法,比较1年前后患者各项生化指标及人体成分指标的差异;并对人体成分同白蛋白的相关性进行分析。结果 与1年前比较,1年后120例血液透析患者前白蛋白降低,铁蛋白、血红蛋白、肌酐均升高,差异有统计学意义(P<0.05)。与1年前比较,1年后120例血液透析患者人体成分分析结果中身体细胞量、蛋白质、骨骼肌含量、去脂体质量、相位角等指标均显著下降,内脏脂肪面积增加,差异均有统计学意义(P<0.05)。按性别分层分析后发现不同性别人群人体成分变化也具有较大差异;相关性分析显示,白蛋白同身体细胞量、蛋白质、骨骼肌量、相位角均呈正相关(P<0.05)。结论 相较于生化指标,身体细胞量、蛋白质、骨骼肌含量、相位角等人体成分指标在维持性血液透析患者的纵向观察中变化更为显著,应重视其在血液透析患者长期营养管理中的作用。

关键词: 肾透析, 营养管理, 生物电阻抗

Abstract: Objective To investigate the longitudinal changes in body composition of patients undergoing maintenance hemodialysis by BIA. Methods Data was collected from patients underwent regular hemodialysis in the hemodialysis center of Yantai Yeda Hospital from January 1, 2020 to February 28, 2023. Data collected from a total number of 120 patients, 61 males and 59 females, aged 29-84 (56.23±13.52), and 50 patients aged over 60. Participants were selected from patients who completed two body composition analysis, and each analysis was completed at least one year apart. Body composition analysis and biochemical indicators such as albumin, prealbumin, creatinine, urea were collected in the month of completing the body composition analysis. Compared the results of laboratory biomarkers and body composition from two tests. Results Compared with one year before, significant differences were discovered that the level of prealbumin (P<0.05) decreased, while ferritin, hemoglobin and creatinine (P<0.05) increased. Body composition analysis showed that indicators like Body Cell Mass, protein, Skeletal Muscle Mass, Fat Free Mass, mineral and Phase Angle were significantly decreased (P<0.05), while Visceral Vat Area increased (P<0.05). After stratified analysis by sex, significant differences of human body composition between different genders were found;Albumin was significantly positively correlated with Body Cell Mass, protein, Skeletal Muscle Mass and Phase Angle in two groups (P<0.05). Conclusion Compared to biochemical indicators, changes in body composition parameters such as body cell mass, protein, skeletal muscle mass, and phase angle are more significant in the longitudinal observation of patients undergoing maintenance hemodialysis. The importance of these parameters in the long-term nutritional management of hemodialysis patients should be emphasized.

Key words: renal dialysis, nutrition management, bioelectrical impedance

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