饮食干预对腹膜透析患者的保护作用  

Protective effect of diet intervention on peritoneal dialysis patients

作　　者：徐芳[1] 李永霞[1] 陈文莉[1] 

机构地区：[1]武汉市中心医院肾内科,430014

出　　处：《临床肾脏病杂志》2016年第11期681-684,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨饮食干预对腹膜透析患者的影响并进行相关分析，为保护腹膜、改善腹膜透析患者的预后提供依据。方法选择我院腹膜透析中心常规入院复查行持续性非卧床腹膜透析治疗的患者，随机分为干预组和对照组；其中干预组58例，平均年龄为（63．2±2．1）岁，腹膜透析时间为6-15个月；对照组62例，平均年龄为（63．2±2．1）岁，腹膜透析时间为5～16个月。干预组采用地中海饮食（Mediterranean Diet，MeDi），而对照组采用传统的饮食指导模式（低盐低脂优质蛋白饮食）；随访时间为5个月，期间对患者饮食进行随访指导。开始第1个月内每周随访1次，以后每半个月1次，第3个月后每个月1次。在入院时及实验6个月后，将2组患者的血压、体质量指数（bodymassindex，BMI）、糖化血红蛋白、血脂、超敏C反应蛋白（high-sensitivity Creactive protein，hs-CRP）、血红蛋白和血白蛋白等指标进行比较。结果①两组患者干预前的基本状况，如病程、年龄、性别等指标差异无统计学意义（P〉0．05）。②除糖化血红蛋白、收缩压、高密度脂蛋白胆固醇外，干预组患者的舒张压、体质量指数、炎症指标（hs-CRP）、血红蛋白和血白蛋白水平较干预前差异均有统计学意义（P〈0．05）；③与对照组相比，除糖化血红蛋白和血脂水平外，干预组患者的血压、体质量指数和炎症指标（hs-cRP）均明显降低（P〈0．05），血红蛋白和血白蛋白水平明显增高（P〈0．05）。结论地中海饮食可帮助腹膜透析患者有效控制血压、保持良好的营养状态及改善微炎症状态。Objective To study the influence of Mediterranean diet on peritoneal dialysis （PD） patients and analyze the correlation between them, thus providing evidence for peritoneal protection, improvement of the prognosis of PD patients. Methods 120 patients in our center for routine review with continuous ambulatory peritoneal dialysis （CAPD） were randomly divided into intervention group and control group： the intervention group consisted of 58 cases with the average age of （63. 20 ± 2. 14） years, and PD through time of 6 to 15 months; control group was made up of 62 examples with the average age of （63. 21 ± 2. 09） years, and PD through time of 5 to 16 months. The patients in the in- tervention group patients were administered with the Mediterranean Diet （Mediterranean Diet, MeDi）, and those in the control group received the traditional pattern of dietary guidelines （low-salt low-fat high-quality protein diet）. During the follow-up period of 6 months, patients received dietary guidance. The patients were followed up once a week for the first month, then once every half month, after the first 3 months, one month for once. When in hospital and 6 months later, blood presstire, body mass index （BMI）, glycosylated hemoglobin, blood lipid level, high-sensitivity C-reactive protein （CRP）, hemoglobin and albumin of patients from both groups were compared. Results （1） There was no significant difference between the two groups in the basic condition before intervention, such as disease course, age and sex. （2） In addition to glycosylated hemoglobin, systolic blood pressure and high density lipoprotein cholesterol, the diastolic blood pressure, BMI, inflammatory index （CRP）, hemoglobin and serum albumin levels in the intervention group were significantly different from those before the intervention. （3） The blood pressure, BMI and inflammatory index （CRP） in the intervention group were significantly lower than those in the control group （P〈0. 05）, and the hemoglobin an

关 键 词：腹膜透析 饮食干预 微炎症状态 

分 类 号：R692[医药卫生—泌尿科学]