基于碳水化合物计数法的低蛋白饮食对早期糖尿病肾病疗效  被引量:12

Effect of Low-protein Diet based on Carbohydrate Counting on Patients with Early Diabetic Nephropathy

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作  者:王卫光[1] 安琳琳 章小艳 童晓清[1] 斯彩娟[1] 余小龙[1] 束龙[1] 郑培奋[1] Wang Weiguang;An Linlin;Zhang Xiaoyan(Zhejiang Hospital,Zhejiang 310013,China)

机构地区:[1]浙江医院,杭州310013

出  处:《医学研究杂志》2020年第5期132-135,共4页Journal of Medical Research

基  金:浙江省卫生厅培育项目(2014PYA002)。

摘  要:目的探讨基于碳水化合物计数法的低蛋白饮食对早期糖尿病肾病(DKD)的疗效。方法选取2017年6月~2018年6月,浙江医院中-美糖尿病中心及肾内科收治的99例住院患者为研究对象,按照数字表法随机分为实验组和对照组,其中实验组51例,对照组48例,对照组给予常规饮食干预,实验组给予以碳水化合物计数法为基础的低蛋白饮食干预(其中包括饮食宣传教育及制定1周标准食谱)。随访3个月,每周电话随访1次,并根据实际病情对实验组患者进行食谱调整。测定干预前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、肌酐(Scr)、尿素氮(BUN)、肾小球滤过滤(GFR)及尿白蛋白排泄率(UAE)、甘油三酯(TG)、总胆固醇(TC)等生化指标;测量身高、体重、血压,并计算患者BMI及干预前后平均动脉压(MAP)。结果与实验前比较,实验组患者FPG、HbA1c、TG等指标均显著下降,差异有统计学意义(P<0.05),TC干预前后比较差异无统计学意义(P>0.05)。对照组患者FPG、HbA1c、TG、TC等指标干预前后比较差异无统计学意义(P>0.05)。经过实验后,对照组和实验组患者MAP、Scr、BUN、UAE均下降,差异有统计学意义,且实验组患者MAP、Scr、BUN、UAE与对照组比较,下降更明显,差异有统计学意义(P<0.05)。两组患者GFR均显著上升,两组比较差异有统计学意义(P<0.05)。结论以碳水化合物计数法为基础的低蛋白饮食可以明显改善早期DKD患者的血糖水平和肾功能,促进其肾功能恢复。Objective To explore the effect of low protein diet based on carbohydrate counting on patients with early diabetic nephropathy.Methods A total of 99 subjects were included from Diabetes Center of China and the United States and Urology Department of Zhejiang Hospital from June 2017 to June 2018.Subjects were divided two group randomly.The control group was intervened by ordinary diet,experimental group was intervened by low-protein diet based on carbohydrate counting including dietary education and standard recipes of a weekly.We would follow-up by telephone once a week,and adjust the recipes of the experimental group according to the patient′s actual condition.Index of fasting blood-glucose(FPG),hemoglobin A1c(HbA1c),serum creatinine(Scr),blood urea nitrogen(BUN),glomerular filtration rate(GFR),urine albumin excretion ratio(UAER),triglyceride(TG),total cholesterol(TC),mean arterial pressure(MAP)were compared before and after 3 month of intervention.Results After the intervention,MAP,FPG,HbA1c,TG reduced observably,and significantly lower in the experimental group than those in the control group.But there was no significant change in TC in both groups.After the intervention,the Scr,BUN,UAE were reduced observably,the GFR was increased observably in both groups,and there was statistic difference in the Scr,BUN,UAE,GFR in both groups.Conclusion Low-protein diet based on carbohydrate counting method can significantly ameliorated the blood glucose level,and promote the recovery of renal function of patients with early diabetic nephropathy.

关 键 词:早期糖尿病肾病 碳水化合物计数法 低蛋白 饮食干预 肾功能 

分 类 号:R587[医药卫生—内分泌]

 

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