补充水解乳清蛋白对胃切除术后患者低蛋白血症及体成分影响的多中心随机对照研究  

Effects of Hydrolyze Whey Protein Supplementation on Hypoproteinemia and Body Composition in Patients After Gastrectomy:A Multicentre Randomized Controlled Study

作　　者：张新胜 张晓伟[2] 陈改云[3] 刘钊 李鹏 安颖 赖必辉 刘鹿 刘玉猛 刘英华 ZHANG Xin-sheng;ZHANG Xiao-wei;CHEN Gai-yun;LIU Zhao;LI Peng;AN Ying;LAI Bi-hui;LIU Lu;LIU Yu-meng;LIU Ying-hua(Department of Nutrition,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Nutrition,Hebei People’s Hospital,Shijiazhuang 050055,China;Department of Nutrition,The First Affiliated Hospital of Zhengzhou University,Zhengzhoo 450003,China;Department of General Surgery,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Nutrition Science and Research Depertment,Inner Mongolia Meng Niu Dairy(Group)Co.,Ltd,Beijing 101107,China)

机构地区：[1]中国人民解放军总医院第一医学中心营养科,北京100853 [2]河北省人民医院营养科,石家庄050055 [3]郑州大学第一附属医院营养科,郑州450003 [4]中国人民解放军总医院第一医学中心普外医学部,北京100853 [5]内蒙古蒙牛乳业股份有限公司营养科学研究部,北京101107

出　　处：《中国食物与营养》2021年第11期57-64,共8页Food and Nutrition in China

基　　金：“十三五”国家重点研发计划“食品安全关键技术研发”专项“保健食品风险评估及功能评价”基础研究项目(项目编号:2018YFC1602100)。

摘　　要：目的:观察口服补充水解乳清蛋白和分离乳清蛋白对胃切除术后患者低蛋白血症、体成分、免疫球蛋白及胃肠症状的影响。方法:筛选解放军总医院第一医学中心、郑州大学第一附属医院和河北省人民医院胃肠外科行胃切除术后一周内诊断为低蛋白血症的患者122例,随机分为水解乳清蛋白组(A组)、分离乳清蛋白组(B组)、常规治疗组(对照组)。分别于干预前、干预7 d、21 d比较各组间3大营养素摄入、体成分变化、血常规、血清蛋白、免疫球蛋白及胃肠道耐受性情况。结果:共有112例患者完成研究,A组36例、B组38例、对照组42例。干预前3组间一般情况均无统计学差异(P<0.05);干预第7天,A组和B组能量、蛋白质和碳水化合物摄入显著高于对照组(P<0.05),且2组血清前白蛋白水平较对照组显著增高(P<0.05);A组和B组腹泻发生比例显著低于对照组,且A组便秘发生比例也显著低于对照组(P<0.05);干预第21天,A组和B组蛋白质摄入量显著高于对照组(P<0.05);A组和B组瘦体重和瘦体重百分比显著高于对照组,而脂肪百分比显著低于对照组(P<0.05);A组血红蛋白和B组红细胞计数显著高于对照组,且A组和B组血清白蛋白和前白蛋白水平较对照组均显著增高(P<0.05)。结论:胃切除术后患者及时口服补充水解乳清蛋白和分离乳清蛋白胃肠耐受好,并可增加术后能量、蛋白质摄入,提高瘦体重,改善血清低蛋白水平。【Objective】To observe the effects of hydrolyzed whey protein and isolated whey protein on hypoproteinemia,body composition,immunoglobulin and gastrointestinal symptoms of patients after gastrectomy.【Method】A total of 122 patients diagnosed with hypoproteinemia within one week after gastrectomy were randomly divided into hydrolyzed whey protein group(group A),isolated whey protein group(group B)and conventional treatment group(control group)for intervention.The effects of intake of nutrients,changes in body composition,blood routine,serum protein,immunoglobulin and gastrointestinal tolerance were compared among three groups at 0,7 and21 days after intervention,respectively.【Result】A total of 112 patients completed the study(group A=36,group B=38,and control group=42).At the beginning of the intervention,there was no statistical difference in general condition among the three groups(P<0.05).On day 7 of the intervention,the intake of energy,protein and carbohydrate in group A and B was significantly higher than that in the control group(P<0.05),and the serum pre-albumin level in group A and B was significantly higher than that in the control group(P<0.05).The incidence of diarrhea in group A and B was significantly lower than that in control group,and the incidence of constipation in group A was also significantly lower than that in control group(P<0.05).On day 21 of intervention,protein intake in group A and B was significantly higher than that in control group(P<0.05).The percentage of lean body weight and lean body weight in group A and B were significantly higher than those in control group,but the percentage of fat in group A and B was significantly lower than that in control group(P<0.05).The hemoglobin and red blood cell counts in group A and B were significantly higher than those in the control group,and the serum albumin and prealbumin levels in group A and B were significantly higher than those in the control group(P<0.05).【Conclusion】Oral supplementation of hydrolyzed whey protein and isol

关 键 词：胃切除术 低蛋白血症 水解乳清蛋白 分离乳清蛋白 人体成分 

分 类 号：R735.2[医药卫生—肿瘤]