限制膳食蛋白营养干预对早期糖尿病肾病患者肾脏功能的影响  

AEffects of Nutrition Intervention by Restricting Dietary Protein Intake on the Renal Function for the Patients with Early Diabetic Nephropathy

作　　者：滑丽美[1] 胡丽叶[2] 雷敏[3] 郭玉文[4] 曹婧然[4] HUA Li-mei;HU Li-ye;LEI Min;GUO Yu-wen;CAO Jing-ran(Department of Nutrition,Bethune International Peace Hospital,Shijiazhuang 050082,China;Department of Endocrinology,Bethune International Peace Hospital,Shijiazhuang 050082,China;Department of Nutrition,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Nutrition,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]解放军白求恩国际和平医院营养科,石家庄050082 [2]解放军白求恩国际和平医院内分泌科,石家庄050082 [3]河北医科大学第三医院营养科,石家庄050051 [4]天津医科大学第二医院营养科,天津300211

出　　处：《临床误诊误治》2018年第4期48-51,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫健委医学重点课题(20150387)

摘　　要：目的探讨限制膳食蛋白营养干预对早期糖尿病肾病患者肾脏功能的影响。方法选取2015年3月—2016年12月首次就诊于解放军白求恩国际和平医院内分泌科的早期糖尿病肾病患者80例,根据营养干预方法的不同分为1.0 g/(kg·d)蛋白组和0.8 g/(kg·d)蛋白组各40例,均严格按照研究设计给予营养干预6个月,每月门诊随访1次。观察比较两组干预前后体重指数(BMI)、腰围、糖化血红蛋白、24 h尿蛋白定量、血肌酐、血清白蛋白水平。结果 0.8 g/(kg·d)蛋白组24 h尿蛋白定量及血肌酐水平均低于1.0 g/(kg·d)蛋白组(P<0.01),但BMI、腰围、糖化血红蛋白、血清白蛋白水平组间比较差异无统计学意义(P>0.05)。结论早期糖尿病肾病患者每日膳食摄入蛋白0.8 g/kg可能更为适宜,既不增加肾脏负担,又能满足机体基本蛋白需求。Objective To probe the effects of nutrition intervention by restricting dietary protein intake on the renal function for the patients with early diabetic nephropathy.Methods A total of 80 patients with diabetic nephropathy admitted to hospital from Mar.2015 to Dec.2016 were randomly divided into two groups:1.0 g/(kg·d)protein group(n=40)and 0.8 g/(kg·d)protein group(n=40)according to different nutritional intervention methods.The patients were followed up every month at nutrition clinic.After six months,the BMI,waist circumference,24 hours urinary protein quantitative,serum creatinine level,serum albumin and glycated hemoglobin of two groups were collected for statistical analysis.Results After the intervention,24-hour urinary protein quantitative and serum creatinine level were lower in 0.8 g/(kg·d)protein group than in 1.0 g/(kg·d)protein group,and there were statistically significant differences(P<0.01).But no significant difference was found in BMI,waist circumference,serum albumin and glycated hemoglobin between the two groups(P>0.05).Conclusion With respect to patients with early diabetic nephropathy,0.8 g/(kg·d)protein intake have more advantages in reducing serum creatinine levels and 24-hour urinary protein quantitative,as compared with patients in 1.0 g/(kg·d)protein group.In addition,0.8 g/(kg·d)of protein is more appropriate for patients with early diabetic nephropathy.

关 键 词：糖尿病 糖尿病并发症 糖尿病肾病 营养疗法 蛋白质 

分 类 号：R587.24[医药卫生—内分泌]