蛋白质对重症脑卒中患者营养状况的影响  

Effects of different intakes of protein on nutritional status in severe stroke patients

作　　者：张力[1] 李则宾[1] 骆彬[2] 李增宁[2] 雷敏[1] 井永敏[1] 

机构地区：[1]河北医科大学第三医院,石家庄050051 [2]河北医科大学第一医院

出　　处：《卫生研究》2014年第6期929-932,共4页Journal of Hygiene Research

基　　金：国家科技支撑计划课题(No.2012BA135B03);河北省卫生厅跟踪计划(No.GL-2011-25)

摘　　要：目的探究不同摄入量的蛋白质对重症脑卒中患者营养状况的影响。方法将89例重症脑卒中患者随机分为3组,按理想体重每天给予等热量(25 kcal/kg)不等量蛋白质的营养支持方案,蛋白质的摄入量为A组0.9 g/kg,B组1.2 g/kg,C组1.6 g/kg。分别于营养干预前1天、干预后第7天和第14天抽取空腹外周静脉血测定血清总蛋白(TP)、血清白蛋白(ALB)、血红蛋白(Hb)、肌酐(Cr)、尿素氮(BUN)并于上述3个时间点测量患者健侧上臂围和健侧小腿围。结果 (1)干预后第14天,A组、B组健侧上臂围、小腿围与干预前、干预后第7天相比均下降,差异有统计学意义(P<0.05)。3组之间差异也有统计学意义(P<0.05)。(2)A组TP、ALB、Hb,B组TP、Hb在研究期间呈持续下降趋势,差异均有统计学意义(P<0.05)。B组ALB在干预后第7天下降,差异有统计学意义(P<0.05)。在干预后第14天,C组ALB、Hb均升高,差异有统计学意义(P<0.05)。3组之间差异也有统计学意义(P<0.05)。(3)A、B两组BUN在干预后第7天、第14天均升高,差异有统计学意义(P<0.05);A组与B组之间差异也有统计学意义(P<0.05);干预后第14天,A组与C组、B组与C组之间BUN差异均有统计学意义(P<0.05)。结论蛋白质供给量为1.6 g/kg的重症脑卒中患者营养状况改善较明显。Objective To investigate the effects of different intake of protein on nutritional indicators in severe stroke patients. Methods 89 patients with severe stroke and NRS-2002 scores not less than 3 were enrolled. The patients were divided into group A, group B and group C by random, and 28 cases were in group A with protein intake at 0.9 g/kg, 30 cases were in group B with protein intake at 1.2 g/kg and 31 cases were in group C with protein intake at 1.6 g/kg, all patients were given the same calories support （25 kcal/kg）. On the day of pre-intervention, the 7th and 14th day of post-intervention, fasting blood samples were collected from every subjects. The total protein（TP）, albumin （ ALB ） , hemoglobin （ Hb ） , creatinine （Cr） , blood urea nitrogen （ BUN ） , midarm circumference（MAC） and calf circumference （CC） were recorded. Resaults （ 1 ） The MAC and CC of health side body decreased on the 14th day post-intervention in group A and group B, the differences were significant compared with pre-intervention and on the 7th day post-intervention （P 〈 0.05 ）, but there were no statistical differences between group A and group B. The index of group C had no significant changes from pre- intervention to the 14th day post-intervention. The differences among the three groups were statistically significant on the 14th day post-intervention （P 〈 0.05）. （2） TP, ALB and Hb in group A were decreased from pre-intervention to the 14th day post-intervention, the differences were statistically significant. The levels of TP and Hb decreased in group B during the observation period, the differences were statistically significant. ALB in group B was decreased on the 7th day post-intervention, but it was increased on the 14th day post-intervention, there was no statistical difference compared with pre-intervention. The levels of TP,ALB and Hb in group C had no significant differences on the 7th day post- intervention, but they all increased on the 14th day post-intervention. The diffe

关 键 词：重症脑卒中 蛋白质 营养支持 

分 类 号：R743[医药卫生—神经病学与精神病学] R459.3[医药卫生—临床医学]