49例肝硬化患者营养不良的相关因素分析

目的:探讨肝硬化患者营养不良的相关因素。方法:已确诊49例肝硬化住院患者空腹测血常规、血生化、肝纤维化、血凝分析、微量元素测定、尿常规,及人体测量学指标:身高、体重(weight)、上臂围(Mid-upperarmcir cumference,AC)、上臂肌围(Mid-upper arm muscle circumference,AMC)、肱三头肌皮褶厚度(Triceps skin fold thickness,TSF)、髂骨上皮褶厚度(Ilium skin fold thickness,ISF)、腓肠肌围((Gastrocnemius muscle circumference,GC),计算体重指数(Body mass index,BMI)、Pignete指数、比胸围(Ratio of Chest circumference and body Height,C/H)、Rohrer指数、Vervaeck指数等指标110项,采用主观全面营养评价法(Subjective global assessment,SGA)进行营养评估。结果:计量资料应用t检验、计数资料应用X2检验进行单因素分析,筛选出与肝硬化营养不良有关的因素26项,纳入Logistic回归向前逐步选择法(似然比)行多因素分析,GC、AC、ISF、阴离子间隙(AG)4项指标的降低与肝硬化患者营养不良的发生有关系。结论:在采用SGA法评估肝硬化患者营养状况时,应注意GC、AC、ISF及AG的变化。

Correlation Factors Analysis of Malnutrition of 49 Patients with Hepatocirrhosis

Objective: To investigate the correlation factors of patients with Hepatocirrhosis and Malnutrition. Methods: 49 patients have been diagnosed with Hepatocirrhosis in our hospital. Their 110 major indicators have been measured, which were fasting blood, including blood analysis, blood biochemistry, liver fibrosis, blood clotting function, tumor markers, trace elements measured, urine analysis, and anthropometric indicators, includes height, weight, mid-upper arm circumference (AC), mid-upper arm muscle circumference (AMC), triceps skin fold thickness(TSF), ilium skin fold thickness(ISF), gastrocnemius circuit(GC), body mass index(BMI), pignete index, the ratio of chest circumference and body height(C/H), rohrer index, vervaeck index and so on. To assessed their nutritional status by subjective global assessment(SGA). Results: The measurement data were analyzed by t test, and the count data were analyzed by X2 test. 26 selected factors were significantly relationship with hepatocirrhosis and malnutrition by single factor analysis. The indices would be analyzed by multiple logistic regression forward stepwise method (likelihood ratio) multivariate analysis. Selected GC, AC, ISF and anion gap (AG) were significantly relationship with Hepatocirrhosis and malnutrition by multi-factor analysis. Conclusion: When estimate patients with hepatocirrhosis''s nutritional status using SGA, should pay more attention to changes of GC, AC, ISF and the AG.