【摘要】 目的:探讨氨甲酰血红蛋白(CarHb)在评价维持性血液透析患者营养状态中的意义。方法:采用高效液相色谱法检测30例维持性血透患者、51例非透析慢性肾衰竭患者和36名健康人的CarHb(μgCV/gHb);血透组计算透前血尿素氮与CarHb比值(BUN/CarHb),并与血清白蛋白(Alb)、校正蛋白质分解率(nPCR)作相关性分析;采用主观综合营养评估(SGA)法评估受试者的营养状态。结果:血透组CarHb高于对照组[(102.5±28.9)vs(30.0±6.1)],低于非透析慢性肾衰竭组(139.9±52.0),差异显著(P<0.01)。非透析慢性肾衰竭患者CarHb与血尿素氮、肌酐呈显著正相关(P<0.01);血透患者CarHb与透前血尿素氮、肌酐无相关性,但BUN/CarHb比值与Alb、nPCR呈显著正相关(P<0.01)。SGA评估显示,血透组营养状况越差,BUN/CarHb比值越低(P<0.01)。结论:BUN/CarHb比值是评价血透患者营养状态的一个可靠指标。更多还原

【Abstract】 Objective:To evaluate the nutritional status in patients on maintenance hemodialysis by determining carbamylated hemoglobin (CarHb). Methods: CarHb was measured by high-performance liquid chromatography (HPLC) in 30 patients who were on maintenance hemodialysis(HD), 51 non-dialysis patients with chronic renal failure(CRF) and 36 healthy controls. The correlation between BUN/CarHb ratio in hemodialysis group and serum albumin (Alb) and the normalized protein catabolic rate (nPCR) was analyzed. The nutritional status was determined by subjective global assessment (SGA). Results: CarHb in hemodialysis group was significantly higher compared with that in control group([102.5±28.9 ] vs [30.0±6.1] μg CV/g Hb, P< 0.01), and lower compared with that of non-dialysis uremic patients ([102.5±28.9] vs [139.9±52.0] μg CV/g Hb,P< 0.01). There was a positive correlation between CarHb,BUN and Scr in non-dialysis uremic patients(P<0.01). The BUN/CarHb ratio was positively correlated with serum Alb and nPCR (P< 0.01)in the hemodialysis group. Assessment by SGA demonstrated that the worse the nutritional status was, the lower the BUN/CarHb ratio was in hemodialysis subjects (P< 0.01). Conclusion: The BUN/CarHb ratio is a reliable index for assessment of nutritional status in hemodialysis patients.更多还原