摘要
目的探讨持续性非卧床腹膜透析（CAPD）患者营养与外周动脉疾病（PAD）的关系。方法应用踝臂指数（ABI）测定仪测定CAPD患者ABI，根据ABI将患者分为PAD组（ABI＜0．9）和非PAD组（ABI≥0．9）。收集患者临床资料，检测相关血生化指标，评估营养状况相关指标：血白蛋白、握力（HGS）、主观综合性营养评估（SGA）。用logistic回归方法分析PAD与营养及其他因素间的关系。结果入选患者102例，PAD的发生率为23．53％（24／102）。营养不良组（SGA评估）ABI显著低于营养良好组[（0．72±0．21）比（1．04±0．14），P＜0．01]。与非PAD组相比，PAD组血白蛋白、HGS、舒张压、血肌酐、血尿素氮显著降低（均P＜0．05），年龄、营养不良（SGA评估）发生率、糖尿病史比例、心血管病史比例显著增加（均P＜0．01）。多因素logistic回归分析结果显示血白蛋白（OR=O．762，95％CI：0．611～0．948，P=O．015）、HGS（OR=O．988，95％CI：0．979～0．997，P=0．0１3）是CAPD患者发生PAD的独立保护因素；营养不良（SGA评估）［OR=21．101，95％CI：5．008～88．901，P＜0．01]是CAPD患者发生PAD的独立危险因素。结论本中心CAPD患者PAD的发生率为23．53％。营养是CAPD患者发生PAD的相关因素。
Objective To investigate the association between nutrition and peripheral artery disease （PAD） in continuous ambulatory peritoneal dialysis （CAPD） patients. Methods One hundred and two stable CAPD patients from a single center were enrolled in this cross-sectional study. Automatic ankle-braehial index （ABI） measuring system was applied to examine ABI. Patients were divided into PAD group （ABI 〈0.9） and non- PAD group （ABI≥0.9）. Clinical data were collected. Biochemical parameters were detected. Nutritional status was evaluated by serum albumin, handgrip strength （HGS） and subjective global assessment （SGA）. Logistic regression analysis was performed to estimate the association of PAD with each nutritional marker as well as other potential risk factors. Results The incidence of PAD was 23.53% （24/102）. ABI was significantly lower in patients with malnutrition as compared to those without malnutrition [（0.72±0.21） vs （1.04±0.14）, P〈0.01]. Compared with non-PAD patients, serum albumin （P〈0.01）, HGS （P〈0.01）, diastolic blood pressure （P〈0.05）, serum creatine （P〈0.05）, blood urine nitrogen （P〈0.01） were significantly decreased, but age （P〈0.01）, the incidence of malnutrition [SGA, P〈0.01], diabetic status （P〈0.01）, cardiovascular disease history （P〈0.01） were significantly increased in PAD patients. Logistic regression analysisshowed that serum albumin （OR=0.762, 95 % CI： 0.611-0.948, P=0.015）, HGS （OR=0.988, 95 % CI： 0.979-0.997, P=0.013） were independent protective factors for PAD, malnutrition [（SGA）, OR=21.101, 95% CI： 5.008-88.901, P〈0.01] was independent risk factor for PAD in CAPD patients. Coneluslons The PAD incidence of CAPD patients in our center is 23.53%. Nutrition is independent factor assoeiated with PAD in CAPD patients.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2014年第8期580-585,共6页
Chinese Journal of Nephrology
基金
国家临床重点专科建设项目（2012649）
河南省基础与前沿技术研究项目（092300410058）
河南省医学科技攻关项目（2011020126）
关键词
腹膜透析
营养不良
外周血管疾病
踝臂指数
Peritoneal dialysis
Malnutrition
Peripheral vascular disease
Ankle brachial index
