【摘要】 目的 :评估改良主观全面营养评价 (SGAN)法对血液透析患者营养状态的评价作用。　 方法 :对 85例维持性血液透析 (MHD)患者分别应用改良SGAN法、传统SGAN法进行营养评估 ;同时测定人体学指标和实验室指标。数据以 x±s表示。组间差异比较采用独立样本t检验。改良SGAN法、传统SGAN法与其它指标的相关性分析分别采用Pearson相关和Spearman相关检验 (非参数检验 )。用偏相关分析作多因素分析。应用SPSS10 0统计软件包进行数据分析。　 结果 :改良SGAN法的MS值 (maluntritionscore)与年龄、肱三头肌皮褶厚度 (TSF)、上臂围(MAC)、上臂肌围 (MAMC)、体重指数 (BMI)、血清白蛋白 (Alb)、C反应蛋白 (CRP)、总铁结合力 (TIBC)均具有显著相关性 (P <0 0 1) ;与谷草转氨酶 (AST)、球蛋白 (GLB)、血清肌酐 (SCr)明显相关 (P <0 0 5 )。传统SGAN法则仅与TSF、MAC、BMI三个指标相关。多因素分析显示 ,在控制年龄、身高、体重三个变量后 ,MS值与CRP、AST、TIBC仍存在相关性 (偏相关系数分别为 0 3381、0 2 476、0 6 0 37,P <0 0 5 ) ,而未发现传统SGAN法与其它指标相关。　 结论 :改良SGAN法对MHD患者有良好的营养评价作用 ,是一种有效的早期营养不良筛选方法。更多还原

【Abstract】 Objective:To evaluate the value of the modified quantitative subjective global assessment of nutrition (SGAN) for the nutritional status in patients with maintenance hemodialysis. Methodology:Eighty-five patients with maintenance hemodialysis were selected in this study.The modified quantitative SGAN and conventional SGAN were used respectively to assess the nutritional status in these patients.At the same time,the anthropometric measurements including mid-arm circumference (MAC),triceps skin-fold thinkness(TSF),calculated mid-arm muscle circumference (MAMC),body mass index (BMI,ratio of weight to square of height),the biochemical parameters,C-reactive protein (CRP) were measured. Results:Malnutrition score,assessing the value of modified SGAN,showed a significant correlation with age,TSF,MAC,MAMC,BMI,the serum albumin concentration,CRP,total iron-binging capacity (TIBC) (P<0.01),AST,serum globulin,and serum creatinine (P<0.05),whereas the conventional SGAN had significant correlation only with TSF,MAC,and BMI.Controlling the variables of age,weight,height,partial correlation showed a significant correlation between the malnutrition score and the combination of the CRP,AST,and TIBC (P<0.05). Conclusion:The modified quantitative SGAN is an effective way for evaluating the nutrition status,and would be a good screening method for detecting early malnutrition in patients with MHD.更多还原