目的 探索维持性血液透析患者营养素养变化轨迹、分析不同轨迹的影响因素并探讨其与衰弱的相关关系,为后期 改善患者衰弱水平提供新的思路和依据。 方法 采用便利抽样法,选取 2023 年 1 月至 2024 年 6 月期间在江苏省人民医院行维 持性血液透析治疗的患者为研究对象,采用基本信息调查问卷、中文版营养素养评估工具及 Tilburg 衰弱量表对入组的调研对 象进行问卷调查。 并通过单因素分析检验不同营养素养剖面的影响因素;采用两两比较分析不同营养素养剖面与衰弱的关 系。 结果 维持性血液透析患者营养素养总得分为(20. 21±4. 37)分、衰弱得分(4. 55±1. 13)分。 将维持性血液透析患者营养 素养分为 3 个潜在剖面类别:高营养素养组、中营养素养组及低营养素养组。 单因素分析:3 个类别组在年龄、学历、居住方式 及透析龄等方面具有显著差异(P<0. 05)。 两两比较结果显示:低营养素养组患者的衰弱水平高于高营养素养组(P<0. 01)和 中营养素养组(P<0. 01),中营养素养组患者的衰弱水平高于高营养素养组(P<0. 05)。 结论 维持性血液透析患者营养素养分 为 3 个潜在剖面类别,不同剖面的营养素养与患者的衰弱水平密切相关。 临床工作人员可针对低营养素养患者积极采用应 对措施,尽可能改善其营养素养状况,对延缓患者衰弱进展、预防不良事件发生有积极作用。

Objective To explore the trajectory of nutritional literacy changes in maintenance hemodialysis patients analyze the influencing factors of different trajectories and explore the correlation with frailty so as to provide new ideas and bases for the improvement of the patients' level of frailty at a later stage. Method Convenience sampling method was used to select patients undergoing maintenance hemodialysis treatment in Jiangsu Provincial People's Hospital during the time period from January 2023 to June 2024 as the study subjects and basic information questionnaire Chinese version of the Nutritional Literacy Assessment Tool and the Tilburg Debilitation Scale were used to conduct questionnaire surveys on the enrolled research subjects. The data were analyzed and tested by one - way analysis and two - by - two comparison. Result The total nutritional literacy score of maintenance hemodialysis patients was 20. 21±4. 37 points and the debilitation score 4. 55±1. 13 points. Nutritional literacy of maintenance hemodialysis patients was categorized into 3 potential profile categories high nutrient literacy group low nutrient literacy group and medium nutrient literacy group. Univariate analysis the 3 category groups were significantly different in terms of age education mode of residence and age on dialysis P < 0. 05 . Two-by-two comparison showed that the level of debilitation of patients in the low-nutrient literacy group was higher than that of the high-nutrient literacy group P < 0. 01 and higher than that of the medium-nutrient literacy low-skill group P < 0. 01 and that of the medium-nutrient literacy low-skill group was higher than that of the high-nutrient literacy group P < 0. 05 . Conclusion Nutritional literacy of maintenance hemodialysis patients was classified into 3 potential profile categories. Nutritional literacy in different profiles was strongly associated with the patients' level of debilitation. Clinical staff can actively adopt countermeasures for patients in the low-literacy group to improve their nutrient literacy status as much as possible which will have a positive effect on delaying the progression of patients' debilitation and preventing the occurrence of adverse events.