复方α-酮酸配伍改良低蛋白饮食对长期血透患者营养状况影响的临床研究  

Clinical Study of Effect of Compound α-Keto Acid Combined with Modified Low Protein Diet on Nutriture of Patients with Chronic Hemodialysis

作　　者：凌志雄 张丽琴 孙蝶丽 袁萍苹 刘肖群 潘妹 熊东玲 王迪 

机构地区：[1]广东省东莞市第八人民医院血液净化中心,广东东莞523325

出　　处：《临床医学工程》2016年第11期1475-1478,共4页Clinical Medicine & Engineering

基　　金：2014年东莞市医疗卫生科技计划一般项目(2014105101212)

摘　　要：目的探讨长时间应用复方α-酮酸(0.12 g·kg-1·d-1)配伍改良低蛋白饮食(0.8 g·kg-1·d-1)对长期血透患者营养状况影响的临床效果。方法选取2013年1月至2014年2月期间在我院长期行血液透析的患者40例进行18个月的随访,根据治疗方案的不同分为两组,均给予常规对症治疗。对照组(18例)蛋白质摄入量为1.2 g·kg-1·d-1,研究组(22例)采用复方α-酮酸(0.12 g·kg-1·d-1)配伍改良低蛋白饮食(0.8 g·kg-1·d-1)治疗,观察两组的营养状况相关生化指标、人体测量学指标、钙磷代谢以及临床效果。结果两组治疗前后的血清白蛋白、血红蛋白、总胆固醇水平、体重指数和上臂肌围比较差异均无统计学意义(P>0.05);但研究组的尿素氮、血清肌酐水平低于对照组,而二氧化碳结合力高于对照组(P均<0.05)。治疗后,对照组血磷、血钙、钙磷乘积、甲状旁腺素激素(i PTH)均升高(P<0.05),而研究组血磷、钙磷乘积均降低(P<0.05),但i PTH与治疗前比较差异无统计学意义(P>0.05)。研究组治疗后各时期i PTH值均明显低于对照组(P均<0.05)。治疗后,研究组的生活质量显著优于对照组(P<0.05)。结论长期血透患者应用复方α-酮酸(0.12 g·kg-1·d-1)配伍改良低蛋白饮食(0.8 g·kg-1·d-1)疗法,能够维持较好的营养状态,并有助于改善其钙磷代谢紊乱和酸中毒,提高生活质量。Objective To explore the clinical effect of long-term application of the compound α-keto acid （0.12 g. kg-1. d-1） combined with modified low protein diet （0.8 g. kg-1. d-1） on nutriture of patients with chronic hemodialysis. Methods 40 cases of patients with chronic hemodialysis in our hospital from January 2013 to February 2014 were selected and divided into two groups according to different treatment, with 18-month follow up. All the patients received conventional symptomatic treatment. The intake of protein of control group （18 cases） was 1.2 g. kg-1. d-1, while the study group （22 cases） received compound α-keto acid （0.12 g. kg-1, d-1） combined with modified low protein diet （0.8 g .kg-1.d-1）. The nutrimre-related biochemical indicators, anthropometric indicators, calcium-phosphorus metabolism and clinical effect of two groups were observed. Results No statistical difference was found in the serum albumin, hemoglobin, total cholesterol levels, body mass index and arm muscle circumference between two groups before and after treatment （P〉0.05）. But the levels of urea nitrogen and serum creatinine of study group were lower than those of control group, but the CO2 combining power was higher （all P 〈0.05）. After treatment, the serum phosphorus, calcium, calcium-phosphate product and parathyroid hormone （iPTH） of control group all increased （P 〈0.05）, while the serum phosphorus and calcium-phosphate product of study group decreased （P 〈0.05）. The iPTH in different periods of study group were significantly lower than those of control group （P 〈0.05）, but has no statistical difference with that before treatment （P 〉0.05）. The quality of life of the study group was significantly higher than that of control group （P 〈0.05）. Conclusions The compound α-keto acid （0.12 g. kg-1. d-1） combined with modified low protein diet （0.8 g. kg-1. d-1） for patients with chronic hemodialysis can maintain good nutriture, help to improve disorders of calci

关 键 词：改良低蛋白饮食 复方Α-酮酸 营养状况 血透 

分 类 号：R692.5[医药卫生—泌尿科学]