应用酮酸疗法改善狼疮性肾炎患者营养状态的研究  

Study of ketoacid therapy on nutritional state of lupus nephritis

作　　者：滕彦波[1] 郭伟[1] 毕黎琦[2] 鲁新[1] 

机构地区：[1]吉林市第二中心医院肾内科,吉林吉林132001 [2]吉林大学中日联谊医院肾风湿科,吉林长春130031

出　　处：《临床荟萃》2005年第12期676-679,共4页Clinical Focus

摘　　要：目的研究酮酸疗法对狼疮性肾炎(LN)患者营养状态的治疗作用。方法选择我院门诊和住院的LN及非狼疮性慢性肾功能不全(NLN)患者共45例,所选患者血清尿素氮(BUN)均大于9mmol/L,血清肌酐(Cr)大于178μmol/L,且无肝脏酶学异常;将LN与NLN患者随机分为两组:实验组为极低蛋白饮食+α酮酸治疗组,对照组为单纯低蛋白饮食治疗组,所有LN或NLN患者其他治疗均相同,患者治疗前及治疗后2周及2个月收集晨起空腹静脉血清,置于-30℃冻存,待批量检测,用酶标法测定血清前白蛋白(PA)、白蛋白(ALB)水平,血清BUN、Cr由我院检验科当日检测。结果酮酸疗法治疗2个月后,实验组较对照组血清BUN明显下降,LN与NLN两个实验组BUN分别为(9.29±4.70)mmol/L、(14.02±7.50)mmol/L,而LN与NLN两个对照组分别为(13.87±6.97)mmol/L、(19.48±7.32)mmol/L(P<0.05);实验组两组血清PA较对照组两组明显增高,分别为(347.99±112.61)mg/L、(381.27±86.13)mg/L和(282.13±66.27)、(352.98±94.21)mg/L(P<0.05)。结论酮酸疗法能够降低LN及NLN患者的血清BUN水平,血清PA是较ALB敏感的反映营养状态的指标,酮酸疗法能够改善LN患者的营养状态。Objective To gain clear idea of the function of the ketoacid theraphy on the nutritional state of lupus nephritis(LN). Methods Forty-five patients who suffered from LN or none lupus nephritis(NLN) were chosen from the outpatients and inpatients department, the serum urea nitrogen(BUN) and serum creatinine(Cr) of these patients were higher than 9 mmol/L and 178 μmol/L, respectively, serum enzymes of these patients were normal. These patients of LN and NLN were randomly divided into two groups: the investigating groups accepted very low protein diet and ketosterile; the control groups accepted simple low protein diet, all the other treatments for the patients of LN or NLN were the same,the patients' fast blood was sampled for following tests:BUN,Cr,the level of serum albumin(ALB) and prealbumin(PA), test of serum ALB and PA were detected by enzyme linked immunosorbent assay. Results After two months of ketoacid therapy,the BUN of investigating groups decreased significantly,LN and NLN groups were respectively ((9.29)±(4.70)) mmol/L,((14.02)±(7.50)) mmol/L,while LN and NLN control groups were respectively((13.87)±(6.97)) mmol/L,((19.48)±(7.32)) mmol/L(P<(0.05)). The level of serum PA of both investigating groups increased more obviously,LN and NLN groups were respectively ((347.99)±(112.61)) mg/L,((381.27)±(86.13)) mg/L,while the two control groups were respectively ((282.13)±(66.27)) mg/L,((352.98)±(94.21)) mg/L(P<(0.05)). Conclusion Ketoacid can decrease the serum BUN of LN and NLN patients markedly. Ketoacid can improve the nutritional state of LN patients, PA is a more sensitive index than ALB in reflecting the nutritional state.

关 键 词：狼疮肾炎 酮酸类 膳食调查 膳食疗法 

分 类 号：R593.242[医药卫生—内科学]