复方α-酮酸结合低蛋白饮食延缓2型糖尿病肾病进展的前瞻随机开放性试验  

Comparison of the Effects of α-keto/Amino Acid Supplemented Low Protein Diet and Diabetes Diet in Patients with Diabetic Nephropathy

作　　者：邱红渝[1] 刘芳[1] 赵黎君[1] 黄颂敏[1] 左川[1] 钟慧[1] 陈凤[1] 

机构地区：[1]四川大学华西医院肾脏内科,成都610041

出　　处：《四川大学学报（医学版）》2012年第3期425-428,共4页Journal of Sichuan University(Medical Sciences)

摘　　要：目的评价复方α-酮酸片剂结合低蛋白饮食延缓2型糖尿病肾病的作用。方法采用前瞻性随机、对照临床研究的方法,将23例2型糖尿病肾病Ⅳ期患者,随机分为治疗组〔低蛋白饮食,蛋白摄入量(DPI):0.6g/(kg.d)+复方α-酮酸1片/(5kg.d)〕和对照组〔常规糖尿病饮食,DPI:0.8g/(kg.d)〕组,治疗疗程52周,检测治疗前和治疗后12、20、36和52周24h尿蛋白量以及治疗52周前后的肾小球滤过率(GFR)、营养状况指标、血糖、血脂以及炎症指标。结果治疗组患者24h尿蛋白均有降低(P<0.05);治疗第20周,治疗组与对照组比较,尿蛋白降低差异有统计学意义(P<0.05)。治疗组与对照组GFR在观察期内保持相对稳定,组间比较差异无统计学意义。治疗组与对照组营养学指标、炎症指标及钙、磷指标在观察期内保持相对稳定,组间比较差异无统计学意义。结论复方α-酮酸片剂结合低蛋白饮食能降低糖尿病肾病尿蛋白水平,延缓肾功能受损,改善患者营养状况。Objective To investigate if α-keto/amino acid supplemented low protein diet can slow down the progression of diabetic nephropathy in comparison with non-supplemented diabetes diet.Methods A prospective,randomized,controlled clinical study was conducted.Twenty three cases of type 2 diabetic nephropathy in Ⅳ stage were randomly divided into α-keto/amino acid supplemented diet group（trial group） and conventional diabetes diet group（control group）,The treatment duration was 52 weeks.24 h urine protein was measured at 0,12,20,36 and 52 weeks.Before and after the 52 weeks treatment,all the patients received the measurement of glomerular filtration rate（GFR）,blood glucose,blood lipids,inflammatory markers,as well as nutritional status.Results After the treatment for 20,36,52 weeks,mean 24 h urine protein decreased significantly in trial groups（P0.05）,and 24 h urine protein in trial group were significantly decreased（P0.05） compared with control group in 20 weeks after treatment.Either in trial group or in control group,GFR remained relatively stable during the observation period.Nutrition status,inflammatory markers,and serum calcium,phosphorus levels between the two groups were no significantly difference.The adverse events experienced by the patients in trial group were similar and consistent with the patients underlying renal diseases.Couclusion α-keto/amino acid can reduce proteinuria more effectively,while improve renal function and nutritional status in diabetic nephropathy patients with well-toleration.

关 键 词：糖尿病肾病 随机对照 Α-酮酸 低蛋白饮食 蛋白尿 

分 类 号：R587.2[医药卫生—内分泌]