个体化医学营养治疗改善糖尿病肾病患者营养状况的研究  

Improvement Effect of Individualized Medical Nutrition Therapy to Improve The Nutritional Status of Patients with Diabetic Nephropathy

作　　者：汪丽丽 孙娴静 张馨怡 王欣 WANG Li-li;SUN Xian-jing;ZHANG Xin-yi;WANG Xin(Department of Renal Medicine,Jiangbei Hospital of Cuhk Affiliated to Southeast University,Nanjing 211500,China;Department of Endocrinology,Jiangbei Hospital of Cuhk Affiliated to Southeast University,Nanjing 211500,China;Department of General Internal Medicine,Wuxi Fifth People’s Hospital,Wuxi 214000,China)

机构地区：[1]东南大学附属中大医院江北院区肾内科,南京211500 [2]东南大学附属中大医院江北院区内分泌科,南京211500 [3]无锡市第五人民医院综合内科,江苏无锡214000

出　　处：《中国食物与营养》2021年第12期72-75,共4页Food and Nutrition in China

基　　金：江苏省科技厅资助项目(项目编号:BE2018047)。

摘　　要：目的:探讨个体化医学营养治疗对改善糖尿病肾病患者营养状况、肾功能损害及炎症反应的影响。方法:选取2019年1月—2021年2月期间来东南大学附属中大医院就诊的糖尿病肾病患者共101例作为研究对象,根据研究方案采用随机数字表法分成对照组(50例)和观察组(51例)。对照组采用传统医学营养治疗的方法,观察组采用个体化医学营养治疗的方法,比较2种方法对DN患者两组患者营养状况、肾功能损害及炎症反应的影响。结果:营养状况指标,治疗后观察组SGA评分结果显示营养正常,对照组SGA评分较治疗前降低,仍处于轻中度营养不良,差异有统计学意义(P<0.05或P<0.01);观察组BMI、血红蛋白(Hb)、血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)指标高于对照组,差异有统计学意义(P<0.05或P<0.01)。肾功能损害指标,治疗后观察组β2微球蛋白(β2-MG)、血肌酐(Scr)、血尿酸(UA)、血尿素氮(BUN)低于对照组,差异有统计学意义(P<0.05或P<0.01)。炎症反应指标,治疗后观察组C反应蛋白水平(CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子α(TNF-α)低于对照组,差异有统计学意义(P<0.05或P<0.01)。结论:个体化医学营养治疗可改善糖尿病肾病患者营养状况、肾功能损害及炎症反应,且疗效优于传统方法,值得临床推广应用。【Objective】To explore the effects of individualized medical nutrition therapy on nutritional status,renal function impairment and inflammatory response in patients with diabetic nephropathy.【Method】A total of 101 patients with diabetic nephropathy who came to Zhongda Hospital affiliated to Southeast University from January 2019 to February 2021 were selected as the subjects.According to the research plan,the patients were randomly divided into the control group(50 cases)and the observation group(51 cases)using random number table.The control group was treated with traditional medical nutrition treatment,and the observation group was treated with individualized medical nutrition treatment.The effects of the two methods on nutritional status,renal function damage and inflammatory response of DN patients were compared.【Result】The indexes of nutritional status,after treatment,the SGA score of the observation group was normal,the SGA score of the control group was lower than that before treatment,and it was still in mild to moderate malnutrition,the difference was statistically significant(P<0.05 orP<0.01).BMI,hemoglobin(Hb),serum albumin(ALB),prealbumin(PA)and transferrin(TRF)in the observation group were significantly higher than those in the control group(P<0.05 orP<0.01).Renal function impairment index,observation group after treatmentβ2 micro globulin(β2-MG),serum creatinine(Scr),serum uric acid(UA)and blood urea nitrogen(BUN)were significantly lower than those in the control group(P<0.05 orP<0.01).Inflammatory response index,observation group after treatment C-reactive protein level(CRP),interleukin-1β(1L-1β),interleukin-6(1L-6),monocyte chemoattractant protein-1(MCP-1),tumor necrosis factor-α(TNF-α)were significantly lower than those in the control group(P<0.05 orP<0.01).【Conclusion】Individualized medical nutrition therapy can improve nutritional status,renal function damage and inflammatory response in patients with diabetic nephropathy,and the curative effect is better than that of tradi

关 键 词：糖尿病肾病 个体化医学营养治疗 营养状况 肾功能 炎症反应 

分 类 号：TS201.4[轻工技术与工程—食品科学] R587.2[轻工技术与工程—食品科学与工程] R692.9[医药卫生—内分泌]