【摘要】 目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者老年营养风险指数(geriatric nutritional risk index,GNRI)与临床指标的相关性。方法 本研究为多中心横断面研究。纳入2019～2020年安徽省宣城市人民医院血液净化中心等29家透析中心2678例MHD患者，收集相关人口学特征、原发病、实验室检查等资料，其中依据白蛋白、身高、体质量等计算老年营养风险指数值，根据老年营养风险指数值分为高营养风险组(GNRI<82)，中营养风险组(82≤GNRI<92)，低营养风险组(92≤GNRI≤98)，无营养风险组(GNRI>98)，单因素方差分析4组间临床指标的差异，多元线性回归分析老年营养风险指数与临床指标的相关性。结果 MHD患者中存在营养风险的占40.3%(1084/2687)，高、中、低营养风险占比分别为3.0%、13.5%和23.7%;Pearson相关分析发现年龄(r=-0.101,P<0.001)、超敏C反应蛋白(r=-0.195,P=0.002)与GNRI呈负相关，血红蛋白(r=0.266,P<0.001)、肌酐(r=0.225,P<0.001)、三酰甘油(r=0.147,P<0.001)、低密度脂蛋白(r=0.089,P<0.001)、胆固醇(r=0.060,P=0.002)、血镁(r=0.113,P<0.001)、血磷(r=0.127,P<0.001)、甲状旁腺激素(r=0.051,P=0.008)与GNRI呈正相关。多元线性回归分析发现MHD患者GNRI与血清肌酐(β=0.070,P<0.001)、三酰甘油(β=0.070,P<0.001)、低密度脂蛋白(β=0.034,P=0.009)独立相关。结论 维持性血液透析患者营养风险比例高，老年营养风险指数是反映血液透析患者营养状态的有用指标。更多还原

【Abstract】 Objective To evaluate the associated between Geriatric Nutritional Risk Index(GNRI) and clinical characteristics in maintenance hemodialysis(MHD) patients. Methods Two thousand six hundred and seventy-eight patients in MHD were recruited. Clinical characteristics of the patients were collected. We divided patients into the highest GNRI group(>98), considered to have no risk of malnutrition, the high GNRI group(92≤GNRI≤98), considered to have a low risk of malnutrition, median GNRI group(82≤GNRI<92),considered to have a median risk of malnutrition, and low GNRI group(<82), considered to have a high risk of malnutrition. Pearson correlation analyses and multiple linear regression analyses were conducted. Results One thousand and eighty-four patients(40.3%) were at risk of malnutrition. Pearson analysis showed that age(r=-0.101, P<0.001) and hypersensitive c reactive protein(hsCRP)(r=-0.195, P=0.002) were negatively correlated with GNRI. Hemoglobin(r=0.266, P<0.001), serum creatinine(r=0.225, P<0.001), triglyceride(r=0.147, P<0.001), low density lipoprotein(r=0.089, P<0.001), cholesterol(r=0.060, P=0.002), serum magnesium(r=0.113, P<0.001), serum phosphorus(r=0.127, P<0.001), parathyroid hormone(r=0.051, P=0.008)were positively correlated with GNRI. Multivariate logistic regression analysis shown that serum creatinine(β=0.070, P<0.001), triglyceride(β=0.070, P<0.001) and low density lipoprotein(β=0.034, P=0.009) were significantly associated with GNRI. Conclusions GNRI may be a reasonable indicator for assessment and monitoring of nutritional status in MHD patients.更多还原