混合淀粉主食在慢性肾脏病患者院外营养管理中的应用  

Applications of mixed starch as staple food in nutritional management in patients with chronic kidney diseases

作　　者：赵旭[1] 兰祥莉 陈容[1] 车昭军 黄小明 ZHAO Xu;LAN Xiang-li;CHEN Rong;CHE Zhao-jun;HUANG Xiao-ming(Department of Nephrology,Yibin Second Hospital of Traditional Chinese Medicine,Yibin 644000,China)

机构地区：[1]四川省宜宾市第二人民医院肾内科,宜宾644000 [2]四川省宜宾市第二中医院内一科,宜宾644000 [3]深圳远东妇产医院营养专科,深圳518001

出　　处：《临床肾脏病杂志》2019年第10期743-747,共5页Journal Of Clinical Nephrology

基　　金：四川省卫生计生委课题(18PJ575)

摘　　要：目的探讨混合淀粉主食在慢性肾脏病(CKD)患者院外营养管理中的应用效果。方法抽取2017年1月至2018年6月宜宾市第二人民医院和第二中医院确诊的CKD 1~4期患者80例,随机分为对照组和混合淀粉组,对照组按照低蛋白饮食进行健康教育,混合淀粉组在此基础上给予红薯淀粉、土豆淀粉和麦淀粉制作的混合淀粉主食替代传统主食,3个月后观察其营养相关指标、肾功能指标及患者主观感受。结果干预后混合淀粉组患者体质量、血红蛋白、白蛋白、患者营养状况、血肌酐、内生肌酐清除率和血尿素氮水平均优于对照组(P<0.05)。且两组患者口味接受度、饱腹感、恶心和呕吐等主观感受差异无统计学意义(P>0.05)。结论混合淀粉主食降低非优质蛋白的摄入,有利于改善患者营养状况和肾功能,可以作为CKD患者院外营养管理中主食的优先选择。Objective To discuss the application of mixed starch as staple food innutritional management in patients with chronic kidney diseases(CKD).Methods A total of 80 CKD patients diagnosed with CKD phase 1~4 in Yibin No.2 People’s hospital and Yibin No.2 TCM Hospital from January 2017 to June 2018 were selected and divided into the control group and the mixed starch group randomly.Those patients in the control group received traditional health education according to low protein diet,while the patients in the mixed starch group were fed with the mixed starch as staple food made up of sweet potato starch,potato starch and wheat starch on the basis of low protein diet.Finally,the indexes of nutritional status,renal function and subjective feelings of patients were observed after 3 months of intervention.Results After intervention,body weight,body mass index,hemoglobin,albumin,nutritional status,serum creatinine,creatinine clearance rate and urea nitrogen level in the mixed starch group were all superior to those in the control group(P<0.05).There were no significant differences of subjective experience including taste acceptance,satiety,nausea and vomiting between 2 groups(P>0.05).Conclusions Mixed starch as staple food may reduce intake of non-high-quality protein,improve nutritional status and renal functions of patients,and can be used as a preferential option for staple food in out-hospital nutrition management of CKD patients.

关 键 词：慢性肾脏病 淀粉主食 营养管理 优质蛋白 营养状况 

分 类 号：R69[医药卫生—泌尿科学]