腹膜透析患者四肢肌肉量变化与膳食摄入的关系  

Relationship between dietary intake and changes of appendicular skeletal muscle in peritoneal dialysis patients

作　　者：邹立琴[1] 路潜[2] 鲁新红[3] 

机构地区：[1]肇庆医学高等专科学校护理系,广东肇庆526020 [2]北京大学护理学院,北京100191 [3]北京大学第三医院肾内科,北京100191

出　　处：《中华临床营养杂志》2015年第5期282-286,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的 探讨腹膜透析患者四肢肌肉量变化情况，分析四肢肌肉量变化与膳食摄入的关系。方法 采用便利抽样方法选择北京大学第三医院肾内科腹膜透析患者114例，在基线、透析后6及12个月采用多频体成分测量仪测评患者的体质量、总肌肉量、四肢肌肉量情况，用3天饮食记录法测评其膳食摄入情况，同时收集患者基线时人口社会学资料及临床资料。结果 透析后12个月的四肢肌肉量比基线时明显减少，差异有统计学意义［（19.27±5.59）kg比 （25.65±6.09）kg，P=0.000］；蛋白质摄入显著减少，差异有统计学意义［（0.85±0.21）g/（kg·d）比 （0.90±0.27）g/（kg·d），P=0.038］；能量摄入显著减少，差异有统计学意义［（128.37±26.67）kJ/（kg·d）比 （137.27±29.23）kJ/（kg·d），P=0.001］。将四肢肌肉量变化量进行3等分，肌肉减少量前1/3组患者的平均蛋白质摄入量（0.82±0.18）g/（kg·d）显著低于肌肉减少量后1/3组的患者（0.91±0.20）g/（kg·d）（P=0.021）。结论 随着腹透治疗的进行，患者四肢肌肉量减少，主要与其蛋白质、能量摄入不足有关，应加强透析患者的膳食管理，以缓解患者四肢肌肉量的衰减。Objective To explore the changes of appendicular skeletal muscle （ASM） in peritoneal dialysis （PD） patients, and to analyze the relationship between ASM changes and dietary intake. Methods One hundred and fourteen PD patients were enrolled in Department of Nephrology, Peking University Third Hospital using convenience sampling. At baseline, and 6 and 12 months after PD, bioelectrical impedance analysis was used to assess the body weight, total muscle mass, and ASM of these patients, and three-day food record was used to assess the dietary intake. Demographics and clinical data were also collected at baseline. Results Compared with baseline, the patients ASM at 12 months after PD decreased significantly [（19.27±5.59）kg vs. （25.65±6.09）kg, P=0.000], the dietary protein intake and energy intake decreased significantly [（0.85±0.21）g/（kg·d）vs. （0.90±0.27）g/（kg·d）, P=0.038; （128.37±26.67）kJ/（kg·d）vs. （137.27±29.23）kJ/（kg·d）, P=0.001]. The patients were divided into three groups based on ASM loss, the mean dietary protein intake of the top-loss 1/3 group was statistically lower than that of the bottom-loss 1/3 group [（0.82±0.18）g/（kg·d）vs. （0.91±0.20）g/（kg·d）, P=0.021]. Conclusions With the continuation of PD, ASM of patients may decrease, which is likely to be mainly related to deficiency in protein and energy intakes. Dietary management should be strengthened in PD patients to alleviate the loss of ASM.

关 键 词：腹膜透析 体成分分析 四肢肌肉量 膳食管理 

分 类 号：R459.5[医药卫生—治疗学]