极低蛋白饮食对终末期尿毒症患者的治疗作用  

The effect of very low protein diet on late stage of chronic renal failure.

作　　者：王健[1] 肖明英 

机构地区：[1]保山市第二人民医院肾内科,云南保山678000 [2]保山市医院内5科

出　　处：《云南医药》2005年第5期406-408,共3页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨极低蛋白饮食对终末期尿毒症患者的治疗作用。方法以54例终末期尿毒症(血清肌酐值大于88.4μmol/L)患者为研究对象,随机分为两组,治疗组33例,予以极低蛋白饮食治疗,平均0.3±0.05g.kg-1.d-1;对照组21例,予以低蛋白饮食治疗,平均0.72±0.04g.kg-1.d-1。分别在治疗6个月时检测两组患者的代谢指标、营养状况指标和肌酐清除率的下降值,治疗组在治疗12个月后再次检测营养状况指标,对两组的各种数据进行比较分析。结果治疗6个月后,与对照组比较,治疗组尿素氮升高的趋势和代谢性酸中毒、高磷血症、低钙血症都得到了明显的抑制(P<0.001或P<0.05),而肌酐清除率的下降速度治疗组比对照组减慢24.8倍,两组的营养状况指标无明显差别。治疗12个月后,治疗组的营养状况指标也未恶化。结论对终末期尿毒症患者予以极低蛋白饮食治疗,能有效改善尿毒症症状和保护残存肾功能,而且不会使营养状况恶化。To explore the effect of very low protein diet on late stage of chronic renal failure （CRF）, and also to explore how does it affect the nutritional state of CRF patients. Methods 54 late stage CRF patients （serum creatinine level 〉 88.4μmol/L） were enrolled into this study, and divided into two group, the treated group which included 33 patients administered with a very low protein diet of 0.3 ± 0.05g·kg body weight^-1·d^-1, and the control group which included 21 patients administered a low protein diet of 0.72 ± 0.04g·kg body weight^-1·d^-1. The metabolism marker, nutritional marker and decline in creatinine clearance of two groups after six months treatment were detected respectively; also, the nutritional marker of treated group after 12 months treatment were detected again. Result After six months treatment, the blood urea nitrogen, metablolic acidosis, hyperphosphatemia and hypocalcemia were significantly suppressed compared to control group （P 〈 0.001 or P 〈 0.05）, the rate of decline in creatinine clearance in treated group was 24.8 folds slower than the control group （ -0.21 ± 0.5ml^-1·min^-1·mon^-1 versus - 5.2 ± 1.4ml^-1·min^-1· mon^-1 ） respectively （ P 〈 0. 001 ）. There was no significant difference on nutritional marker between two groups. After 12 months treatment, the nutritional state of treated group did not deteriorated. Conclusion A very low protein diet is effective in amelioration of uremic symptoms and preventing deterioration in renal function, and does not lead to deterioration of nutritional state in late stage chronic renal failure patients.

关 键 词：尿毒症 极低蛋白饮食 

分 类 号：R692.5[医药卫生—泌尿科学]