复方α酮酸对维持性血液透析患者钙磷代谢的影响  

Effect of a-ketoacid on calcium and phosphate metabolism in maintenance hemodialysis patients

作　　者：贾琳[1] 陈文莉[1] 石晶[1] 

机构地区：[1]武汉市中心医院肾内科,430014

出　　处：《临床肾脏病杂志》2011年第8期360-362,共3页Journal Of Clinical Nephrology

摘　　要：目的评估复方α酮酸配合低蛋白质饮食对维持性血液透析患者钙磷代谢及营养状况的影响。方法选择我院维持性血液透析患者40例，随机分为2组，每组20例，观察组给予复方α酮酸加低蛋白质饮食；对照组给予碳酸钙，不限蛋白质饮食，共观察6个月。比较2组血磷、血钙、全段甲状旁腺素（iPTH）及患者体质量指数（BMI）、血红蛋白（Hb）、血浆白蛋白（Alb）、上臂肌围（MAMC）。结果与治疗前相比，治疗后，对照组血磷、血钙、钙磷乘积、iPTH呈升高趋势（P〈0．05或P〈0．01），观察组血磷呈降低趋势（P〈0．01），血钙、钙磷乘积呈升高趋势（P〈0．05），iPTH无变化（P〉0．05）。与治疗前相比，治疗后，2组BMI、Hb、Alb、MAMC均呈升高趋势（P〈0．05），组间无差异（P〉0．05）。结论复方α酮酸配合低蛋白质饮食可在不导致患者营养不良的同时有效纠正患者钙磷代谢紊乱。Objective To evaluate the effect of α-ketoacid combined with low phosphorus and protein diet on calcium and phosphate metabolism and nutritional status in hemodialysis patients. Methods A total of 40 hemodialysis patients were investigated and followed-up for half a year. They were randomly assigned to a low phosphorus and protein diet supplemented with α-ketoaeid （observation group） or a routine protein diet supplemented with calcium carbonate （control group）. Serum calcium, phosphate and intraoperative parathormone （iPTH） were assayed. Serum albumin （Alb）, hemoglobin （Hb）, body mass index （BMI）, and mid-arm muscle circumference （MAMC） were also measured af- ter the treatment for 6 months. Results In control group, serum calcium, phosphate, calcium and phosphate product and iPTH levels were increased significantly （P〈0. 05 or P〈0. 01）. In observα- tion group, phosphate level was decreased （P〈0. 01）, serum calcium and calcium and phosphate product were increased （P〈0. 05）. iPTH remained stable in a low level （P〉0. 05）. Alb, Hb,BMI and MAMC were increased significantly in both two groups （P〈0. 05）, but these values had no significant differences before and after the treatment （P〉0. 05）. Conclusions Low phosphate and protein diet supplemented with α-ketoacid seems to relieve nutritional status and improves calcium and phosphate metabolism in hemodialysis patients.

关 键 词：肾透析 钙磷代谢 营养状况 

分 类 号：R459.5[医药卫生—治疗学]