持续性非卧床腹膜透析患者膳食调查及营养状况  

Dietary survey and nutritional status of the patients with continuous ambulatory peritoneal dialysis

作　　者：李季芳[1] 符乃尹 郑晓东 黎艺[1] 魏佳莉[2] LI Ji-fang;FU Nai-yin;ZHENG Xiao-dong;LI Yi;WEI Jia-li(Department of Clinical Nutriology and,Hainan General Hospital,Haikou 570311,China;Department of Nephrology,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院营养科,海口570311 [2]海南省人民医院肾内科,海口570311

出　　处：《中国血液净化》2020年第7期440-444,共5页Chinese Journal of Blood Purification

基　　金：项目名称及编号:2019年海南省重点科技专项,ZDYF2019126。

摘　　要：目的通过膳食调查了解持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者食物和膳食营养素摄入量,评估膳食营养素摄入量对CAPD患者营养需求的满足程度,为合理营养干预提供科学依据。方法采用24h膳食回顾法对70例CAPD患者进行膳食调查。根据每日蛋白质摄入量(daily protein intake,DPI)水平将患者分为膳食蛋白摄入正常组[DPI≥1.08g/(kg·d)]和膳食蛋白摄入不足组[DPI<1.08g/(kg·d)],评价2组患者每日食物及营养素摄入量并进行营养不良的评定。结果 70例CAPD患者中有54例(77.1%)膳食蛋白质摄入量不足。与膳食蛋白摄入不足组相比,膳食蛋白摄入正常组的谷薯类、蔬菜类、禽畜类的摄入量多(Z值分别为-3.089,-2.088,-3.465;P值分别为0.002,0.037,0.001)。膳食蛋白摄入正常组的每日能量摄入量(daily energy intake,DEI)及DPI高于膳食蛋白摄入不足组(t值分别为4.400,8.562;P值分别为<0.001,<0.001)。与膳食蛋白摄入不足组相比,膳食蛋白摄入正常组的总蛋白和动物蛋白摄入量多(t值分别为6.171,5.246;P值均为<0.001),植物蛋白摄入量少(t=3.387,P=0.001),动物蛋白占总蛋白比例超过60%(t=2.216,P=0.031)。与膳食蛋白摄入不足组相比,膳食蛋白摄入正常组的维生素A、维生素B1、维生素B2、维生素C、维生素PP(t值分别为2.841,4.821,4.314,2.480,5.109;P值分别为0.006,<0.001,<0.001,0.016,<0.001)、钾、钠、钙、镁、铁、锰、锌、铜、磷、硒(t值分别为5.003,2.500,2.593,4.359,5.660,3.443,5.721,4.480,5.789,3.065;P值分别为<0.001,0.016,0.012,<0.001,<0.001,0.001,<0.001,<0.001,<0.001,0.003)摄入量多。结论 CAPD患者普遍存在膳食摄入不足的问题,膳食蛋白质摄入量不能满足CAPD患者营养需求,膳食蛋白摄入不足组患者膳食营养摄入状况较膳食蛋白摄入正常组差,建议加强营养宣教和个体化的饮食指导。Objective To investigate food and nutritional intake in the patients with continuous ambulatory peritoneal dialysis(CAPD) so as to provide scientific evidences for nutrition intervention in these patients.Methods A retrospective survey of diet in 24 hours was performed in 70 CAPD patients. Based on the daily protein intake(DPI), they were divided into group I [normal DPI group, DPI ≥ 1.08 g/(kg·d)] and group Ⅱ[DPI insufficient group, DPI <1.08 g/(kg · d)]. Dietary survey and nutritional status were evaluated in the two groups. Results The incidence of insufficient DPI was 77.1%(54 cases) in the 70 CAPD patients. The intakes of cereals, vegetables, meat and poultry were significantly higher in group I than in group Ⅱ(Z=-3.089,-2.088 and-3.465 respectively;P=0.002, 0.037 and 0.001 respectively). The daily energy intake(DEI) and DPI were significantly higher in group I than in group Ⅱ(t=4.400 and 8.562 respectively;P<0.001). The intakes of dietary protein and animal protein were significantly higher in group I than in group Ⅱ(t=6.171 and5.246 respectively;P<0.001), while the intake of plant protein was significantly lower in group I than in group Ⅱ(t=3.387, P=0.001). The intakes of vitamins A, B1, B2, C and PP were significantly higher in group I than in group Ⅱ(t=2.841, 4.821, 4.314, 2.480 and 5.109 respectively;P=0.006, <0.001, <0.001, 0.016 and<0.001 respectively). The intakes of potassium, sodium, calcium, magnesium, iron, manganese, zine, copper,phosphorus and selenium were significantly higher in group I than in group Ⅱ(t=5.003, 2.500, 2.593, 4.359,5.660, 3.443, 5.721, 4.480, 5.789 and 3.065 respectively;P<0.001, 0.016, 0.012, <0.001, <0.001, 0.001,<0.001, <0.001, <0.001 and 0.003 respectively). Conclusions Lower dietary intake in CAPD patients was common, and protein intake was much lower than the recommended amount. The dietary nutritional status was worse in group Ⅱ than in group I. Effective measures of nutritional education and individualized dietary instructions should be taken to imp

关 键 词：膳食调查 腹膜透析 蛋白质 

分 类 号：R151[医药卫生—营养与食品卫生学]