营养治疗在血液透析中应用  

Application of nutritional treatment in hemodialysis

作　　者：冯菡芳[1] 张雪琪[1] 程威英[1] 朱汉威[1] 温莉萍[1] 马济民[1] 左静南[1] 候积寿 吴靖川[2] 

机构地区：[1]上海第二医科大学附属新华医院肾内科,200092 [2]上海第二医科大学附属新华医院核医学科

出　　处：《肾脏病与透析肾移植杂志》1993年第1期54-57,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：16例尿毒症血透患者分成三组。第一组6例常规维持血透,自由进食;第二组5例低蛋白饮食,蛋白量为0.6g·kg^(-1)/a,第三组5例极低蛋白饮食,蛋白量为0.3～0.4g·kg^(-1)/d,供给必需氨基酸或酮酸。二、三组每周血透1次,所有患者均观察6个月。结果示三组患者营养状态相似,氮平衡、总体氮流量、蛋白合成速度均有改善,二和三组患者血磷明显降低,血钙明显升高,其Ccr下降率明显慢于一组,提示血透联合低蛋白饮食或(和)加必需氨基酸可以减少血透次数,能保护残存肾单位功能。16 uremic patients were divided into 3 groups, Group Ⅰ consisted of 6 patients, who took free diet and were maintained with hemodialysis (HD) twice or thrice a week; Group Ⅱ, 5 patients, took low protein diet of 0.6g·kg^(-1)/day; Gronp Ⅲ, 5 patients, took very low protein diet of 0.3～0.4g·kg^(-1)/day, supplemented by essential amino acids and/or ketoanalogues. Both group Ⅱ and group Ⅲ patients were on maintenant HD once a week. All patients were observed for 6 months. The results showed that there was no significant difference in nutritional status among the 3 groups of patients; Nitrogen balance, whole body nitrogen flax and rate of protein synthesis were improved in all 3 groups. In group Ⅱ and group Ⅲ patient, serum phosphate levels were lowered markedly, while serum calcium rised significantly. The decline rate of Ccr was markedly slowed in group Ⅱ and Ⅲ as compared with group Ⅰ. It is suggested that infrequent HD combined with protein restriction may protect residual renal function.

关 键 词：血液透析 低蛋白饮食 必需氨基酸 

分 类 号：R5[医药卫生—内科学]