对慢性肾脏病患者个体化目标营养管理的调查分析  

Investigation on the nutritional management of patients with chronic kidney disease

作　　者：杨艳[1] 丁发贤[1] 马潇[1] 郭俊含 王沁园[1] 王静[1] 

机构地区：[1]兰州大学第二医院肾内科,甘肃兰州730000

出　　处：《河北医科大学学报》2017年第5期525-528,534,共5页Journal of Hebei Medical University

摘　　要：目的调查慢性肾脏疾病(chronic kidney disease,CKD)患者膳食摄入中宏量营养素的达标率及蛋白质-能量消耗(protein-energy wasting,PEW)的发生率,分析膳食摄入情况。方法选取兰州大学第二医院住院的CKD患者354例,采用食物称重法和3d24h膳食记录法收集食物消费数据,应用《中国食物成分表》计算营养素的摄入量,统计CKD1~5期患者能量、蛋白、脂类、碳水化合物、白蛋白(albumin,Alb)、血红蛋白(hemoglobin,Hb)、体质量指数(body mass index,BMI)的达标率和PEW发生率,CKD1~5期患者豆类、白肉类、红肉类、蛋类、奶制品、主食类、油脂类、水果类、蔬菜类的9大类食品的摄入量。结果 354例CKD1~5期患者能量达标总人数为88例(24.8%),蛋白质总达标32例(9.0%),脂质总达标51例(14.4%),碳水化合物达标88例(24.8%),Alb达标173例(48.9%),Hb达标117例(33.0%),BMI达标165例(46.6%)。随着CKD进展,CKD各期的上述指标达标率基本是降低的,而PEW发生率是逐渐增加的。CKD1~5期患者豆类、白肉类、红肉类、蛋类、奶制品、主食类、油脂类、水果类、蔬菜类的9大类食品摄入量随着CKD病情的加重也不同程度降低。结论 CKD患者膳食摄入的宏量营养素(蛋白质、脂类、碳水化合物)达标率低下而PEW发生率高;膳食以主食类为主,主要缺乏优质蛋白、蔬菜及水果。因此,所有CKD患者需要进行目标营养管理,实行个体化膳食指导甚至营养治疗。Objective To investigate the compliance rate of macro-nutrients of dietary intake, the incidence of protein energy wasting（PEW） and food consumption data in patients with chronic kidney disease（CKD）. Methods A total of 354 CKD patients hospitalized in Lanzhou University Second Hospital were enrolled in this study. The food consumption data were collected by weighing method combined with 3 consecutive 24-hour recalls, and the nutrients intake was calculated by China Food Composition Table. Nutrition-related indexes were analyzed, which included energy, protein, lipid, carbohydrate, albumin,hemoglobin, body mass index（BMI）, incidence of PEW, and consumption data of nine categories food, such as beans, white meat, red meat, eggs, dairy products, staple foods, oils, fruits and vegetables. Results In 354 patients with the stages CKD1- 5, the number of patients reached the energy recommendation was 88 and compliance rate was 24.8%. The number of patients reached the protein recommendation was 32 and compliance rate was 9.0%. The number of patients reached the lipid recommendation was 51 and compliance rate was 14.4%. The number of patients reached the carbohydrate recommendation was 88 and compliance rate was 24.8%. The number of patients reached the albumin recommendation was 173 and compliance rate was 48.9%. The number of patients reached the albumin recommendation was 117 and compliance rate was 33.0%. The number of patients reached the BMI recommendation was 165 and compliance rate was 46.6%. In total, these indexes mentioned above were gradually decreased but the incidence of PEW was increased with the progress of CKD. The intake of nine categories food, like beans, white meat, red meat, eggs, dairy products, staple foods, oils, fruits and vegetables was inclined with the progression of the disease. Conclusion The compliance rate of dietary intake of three macro-nutrients, such as protein, lipid, carbohydrate, is low and the incidence of PEW is high in patients with CKD. The diets among CKD patients a

关 键 词：肾功能衰竭 慢性 营养疗法 蛋白质能量消耗 

分 类 号：R692.5[医药卫生—泌尿科学]