低蛋白饮食治疗对延缓糖尿病肾病慢性肾衰进展的疗效分析  

Analysis of clinical treatment in the low but high quality protein diet on delaying progress of chronic renal failure suffered from Diabetic nephrophathy

作　　者：沈良儒[1] 张丽丽[1] 张云[1] 

机构地区：[1]江苏省泗洪县人民医院肾内科,江苏泗洪223900

出　　处：《右江医学》2004年第5期420-421,共2页Chinese Youjiang Medical Journal

摘　　要：目的　观察在不补充α 酮酸或必需氨基酸的前提下 ,给优质低蛋白饮食治疗对糖尿病肾病 (DN)所致慢性肾衰 (CRF)患者肾功能进展情况的影响。方法　 5 4例慢性肾功能不全患者按实际蛋白摄入量分为两组 ,优质低蛋白饮食治疗组 (LPD　蛋白质摄入量为 0 .60± 0 .0 7g .kg- 1 .d- 1 ) 3 4例 ,正常蛋白饮食组 (蛋白质摄入量为 1.0± 0 .0 6g·kg- 1 ·d- 1 ) 2 0例 ,观察患者顺应性及肾功能进展情况。结果　患者对低蛋白饮食有良好的耐受性 ,3 4例患者都能坚持LPD治疗。LPD组和正常蛋白饮食组肾功能不全下降速度分别为 0 .2 62± 0 .0 15ml·min- 1 ·月 - 1 和 0 .684± 0 .0 86ml·min- 1 ·月- 1 ,LPD组显著慢于正常蛋白饮食组 (P <0 .0 1) ,LPD组患者平均 62 .6± 8.6个月进入透析治疗 ,而正常蛋白饮食组平均 2 6.4± 3 .5个月进入透析治疗 ,比LPD组提前 3～ 4年。结论　LPD在不补充α 酮酸或必需氨基酸的前提下 ,患者有良好的耐受性 ,并能有效延缓慢性肾衰的进展 ,推迟开始透析治疗的时间 ,成为延缓DN所致慢性肾衰进展的重要方法之一。Objective To investigate the effects of treatment of long-term use of low but high quality protein diet(LPD), which delaying the kidney function's progress on patients with chronic renal failure without supplement of αketo-acid and essential amino acid .Methods Fifty four patients with severe chronic renal failure(CRF)(SCr287.6±86.8μmol/L),CCr(30.68±5.26ml·min -1) were divided into two groups according to their actual protein intake:34 patients with intake of low but high quality protein (0.60±0.07 g·kg -1·d -1) were in LPD Group, while the other 20 patients with normal protein intake(1.0±0.06 g·kg -1·d -1 ) were in control group, The compliance and the development of the kidney’s function of CRF were observed.Results All patients in LPD Group showed good compliance to low protein diet and could continue this LPD treatment; The decreasing speed of GFR in LPD group was(0.262±0.015 ml·min -1·m -1) was obviously slower than that(0.684±0.086 ml·min -1·m -1) in control group (P<0.01). Dialysis in LPD group were average of 62.6±8.4 months, while dialysis in the Normal Protein Diet Group were 6.4±3.5 months. The date of dialysis was postponed for 3 to 4 years in LPD group.Conclusion Without essential amino acids (EAAs) or αketo-acid supplement, all patients in LPD group have good compliance and delayed progress of chronic renal failure effectively and postponed the date of dialysis, and it is one of the most important methods to delay progress of the chronic renal failure suffered from diabetics.

关 键 词：患者 治疗 低蛋白饮食 慢性肾衰 LPD 延缓 正常 结论 实际 补充 

分 类 号：R587.2[医药卫生—内分泌]