慢性肾脏病患者饮食磷摄入现状及与钙磷代谢相关性研究  

Status of dietary phosphorus intake and its correlation with calcium and phosphorus metabolism in patients with chronic kidney disease

作　　者：罗芳[1] 朱雪丽 刘小兰[1] 唐晓娟[1] LUO Fang;ZHU Xue-li;LIU Xiao-lan;TANG Xiao-juan(West China Hospital(West China School of Nursing),Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院(华西护理学院),四川成都610041

出　　处：《华南预防医学》2021年第10期1254-1257,共4页South China Journal of Preventive Medicine

摘　　要：目的探讨慢性肾脏病患者饮食磷摄入情况,并分析饮食中磷摄入量对血营养指标及钙磷代谢相关指标的影响。方法以2018年12月至2019年11月成都市某医院诊治的慢性肾脏病患者为研究对象,进行基本资料收集、3 d 24 h膳食调查、营养状态评估及血生化指标检测,采用描述流行病学分析方法对慢性肾脏病患者饮食磷摄入量进行分析。结果共对151例慢性肾脏病患者进行研究,患者年龄25~75岁,以60~75岁为主,占64.9%,男女性别比为1.25∶1,疾病分期以3期为主,占49.0%,原发病以肾小球肾炎为主,占70.9%,主观营养评估(SGA)法评定结果以B级(可疑营养不良)为主,占86.1%。饮食磷摄入量以中等水平(600~800 mg/d)为主,占58.6%,其次是高水平(>800 mg/d),占23.6%,摄入量低水平(<600 mg/d)的占17.8%。不同饮食磷摄入量的慢性肾脏病患者白蛋白、前白蛋白、血磷、血磷钙乘积指标差异均有统计学意义(均P<0.01),转铁蛋白、血钙水平在不同饮食磷摄入量慢性肾脏病患者中的差异均无统计学意义(均P>0.05)。血磷及血钙磷乘积与饮食磷摄入量呈正相关(rs=0.736、0.809,均P<0.05)。结论饮食磷摄入量对慢性肾脏病患者的营养状况和磷代谢有一定影响,慢性肾脏病患者应注意按营养师的指导注意挑选钾含量较低的食物,在保证机体生理需求前提下,有效控制磷的摄入量,预防高磷血症的发生。Objective To investigate the dietary phosphorus intake of patients with chronic kidney disease(CKD),and to analyze the effect of dietary phosphorus intake on blood nutritional indicators and related indicators of calcium and phosphorus metabolism.Methods Patients with CKD diagnosed and treated in a hospital in Chengdu from December 2018 to November 2019 were taken as the research object. Basic data collection,3 d 24 h diet survey,nutritional status assessment,and blood biochemical detection were carried out. Descriptive epidemiological analysis method was used to analyze the dietary phosphorus intake of patients with CKD.Results A total of 151 patients with CKD were studied,aged 25-75 years,mainly 60-75 years old,accounting for 64.9%. The male to female ratio was 1.25∶1. The disease stage was mainly stage 3,accounting for 49.0%;the primary disease was glomerulonephritis,accounting for 70.9%;and the SGA assessment result was mainly B grade(suspected malnutrition),accounting for 86.1%. The dietary phosphorus intake was mainly at the medium level(600-800 mg/d),accounting for 58.6%,followed by the high level(>800 mg/d),accounting for 23.6%,and the low level(<600 mg/d)accounted for 17.8%. There were statistically significant differences in albumin,prealbumin,blood phosphorus,and blood phosphorus calcium product indexes among patients with CKD with different dietary phosphorus intakes(all P<0.01),but there was no significant difference in transferrin and blood calcium levels among patients with CKD with different dietary phosphorus intake(both P>0.05). Blood phosphorus and blood phosphorus calcium product were positively correlated with dietary phosphorus intake(rs=0.736,0.809,both P<0.05).Conclusion Dietary phosphorus intake has a certain impact on the nutritional status and phosphorus metabolism of patients with CKD. Patients with CKD should pay attention to selecting foods with low potassium content according to the guidance of nutritionists,effectively control phosphorus intake and prevent hyperphosphatemia on th

关 键 词：磷摄入量 慢性肾脏病 营养状况 钙磷代谢 

分 类 号：R153.9[医药卫生—营养与食品卫生学]