终末期肾病患者初始透析时营养状况和白蛋白水平改变及临床意义  

EFFECTS AND SIGNIFICANCE OF DIFFERENT THERAPIES ON MALNUTRATION AND SERUM ALBUMIN LEVEL IN PRO-DIALYSIS STAGE OF END STAGE RENAL DISEASE(ESRD) PATIENTS

作　　者：刘建军[1] 于明忠[1] 裴荣光 赵会文[1] 郭瑞敏[1] 董军[1] 

机构地区：[1]华北煤炭医学院附属医院,唐山063000 [2]滦县人民医院

出　　处：《现代预防医学》2010年第18期3556-3558,共3页Modern Preventive Medicine

基　　金：河北省科技厅研究与发展计划项目(072761247)

摘　　要：[目的]回顾性调查126例终末期肾病(ESRD)患者初始透析时营养状况以及蛋白水平,并分析透析前不同治疗方式对营养状况及白蛋白水平的影响。[方法]对126例ESRD患者进行分组,分为治疗组、非治疗组,治疗组又分为复方α酮酸治疗组(α酮酸组)和非复方α酮酸治疗组(非α酮酸组)。对患者初始透析时的营养状况进行主观综合性营养评估法(SGA法)评分,并检测白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TF)以及肌酐(Scr)、尿素氮(BUN)。[结果]ESRD患者中,治疗组SGA评分及Alb、PA、TF优于非治疗组,α酮酸治疗组SGA评分及Alb、PA、TF优于非α酮酸治疗组,均P﹤0.05,差异有统计学意义。[结论]对慢性肾脏病(CKD)患者进行合理的治疗以及补充复方α酮酸制剂可以延缓其ESRD进展速度以及改善ESRD患者初始透析时的营养状况。[Objective] To evaluate the effects and significance of medical therapy and medical therapy combination with α ketoacid on malnutration status and serum albumin level in prodialysis stage of end stage renal disease patients.[Methods] We recruited 126 cases of prodialysis stage of ESRD patients in this study.The patients were divided two groups including medical therapy and non medical therapy,and medical therapy group can be divided into therapy with α ketoacid and therapy without α ketoacid.And the malnution level according to subjective global assessment（SGA）,and serum albumin,proalbumin,transferrin and BUN,and serum creantine were measured.[Results] SGA,The mean of surum albumin,proal-bumin,transferrin and the mean duration from CKD were diagnosed to prodialysis in non medical therapy group and medical therapy combination group without α ketoacid decreased,and both of them were significant lower than control groups.The differences of BUN and creantine were not observed.[Conclusion] The reasonable,especially medical therapy with α ketoacid is one way to improve malnutrition level and protect kidney function,check the progress of disease,and improve ESRD prognosis on CKD patients.

关 键 词：终末期肾病 蛋白质和能量营养不良 白蛋白 前白蛋白 Α酮酸 

分 类 号：R692[医药卫生—泌尿科学]