鼻饲极低蛋白匀浆联合α酮酸疗法对老年慢性肾功能不全患者营养状况的影响  

Effects of Nasal Feeding Low Protein Homogenate plus αKeto Acid Therapy on Nutritional Status of Elderly Patients with Chronic Renal Insufficiency

作　　者：李峰[1] 朱旭峥[1] 张新胜[2] 

机构地区：[1]空军总医院临床营养科,北京100142 [2]解放军总医院临床营养科,北京100100

出　　处：《现代生物医学进展》2011年第14期2752-2755,共4页Progress in Modern Biomedicine

摘　　要：目的:评估鼻饲极低蛋白匀浆饮食联合α酮酸疗法是否延缓慢性肾功能衰竭(CRF)老年患者病情发展,改善患者营养状况。方法:将我院收治的无法耐受常规低蛋白饮食治疗的肾功能衰竭的老年患者,共24例,随机分为两组,每组12例,一组病人给予极低蛋白匀浆饮食联合α酮酸治疗,为α酮酸组;一组病人给予单纯低蛋白匀浆饮食,为低蛋白组,均进行了6个月的治疗,然后调查患者营养状况。结果:治疗后两组患者的血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)水平较治疗前上升,无明显营养不良,但α酮酸组上升幅度更大(P<0.05)。与治疗前相比,α酮酸组患者经治疗后,血胆固醇(CH)、三酰甘油(TG)、磷(P)水平均下降,血钙(Ca)水平上升(P<0.05),上述指标在低蛋白组无显著性改变。两组患者治疗后血肌酐(Cr)和尿素氮(BUN)在治疗期间均保持稳定。结论:①极低蛋白匀浆饮食联合α酮酸疗法和单纯低蛋白匀浆饮食治疗在短期内均可延缓慢性肾功能不全进展并改善营养状况,而且前者效果更优;②联合α酮酸治疗对改善血脂和钙磷代谢紊乱具有明显作用,单纯低蛋白肠内营养治疗无显著作用。Objective： To investigate whether the treatment of nasally feeding very low protein homogenate with αketoacid de-lay the progression of chronic renal failure and improve the nutrition status of patient.Methods： 24 aged patients of chronic renal failure who couldn＇t afford to the treatment of feeding ordinary low protein were randomly divided into two groups,12 patients in each group.Very low protein homogenate with αketoacid was administrated to the patients in one group,called αketoacid group,while only low protein homogenate was administrated to the patients in the other group,called low protein group.The treatment was carried out for 6 months,then the nutrition status of all patients was investigated.Results： The levels of the serum total protein（TP）,albumin（ALB） and prealbumin（PA） in both group after treatment were higher than the levels before the treatment,but the rising amplitude in the αketoacid group was larger（P0.05）.Compared with the level before the treatment,the levels of blood cholesterol（CH）,blood triglyceride（TG）,phosphorus（P） in the αketoacid group were descent（P0.05）,and the level of blood calcium（Ca） was ascent（P0.05）,while there were no significant improvement in the levels of all the above-mentioned indicators in the low protein group.The levels of blood creatinine（Cr） and blood urea nitrogen（BUN） in both group kept stable during the treatment.Conclusion： 1.The treatment of nasally feeding very low protein homogenate with αketoacid and the treatment of only nasally feeding low protein homogenate both delay the progression of chronic renal failure and improve the nutrition status of patient and the former is better.2.The treatment with αketoacid improve blood lipid and adjust the metabolic disorders of Ca and P.

关 键 词：低蛋白匀浆饮食 Α酮酸 慢性肾功能不全 肠内营养 

分 类 号：R692.5[医药卫生—泌尿科学]