复方α-酮酸改善腹膜透析营养不良患者营养状况的作用机制研究  

Study on the Mechanism of Compoundα-keto Acid Improving Nutri⁃tional Status of Malnourished Patients on Peritoneal Dialysis

作　　者：陈萱[1] 周敏 赵金文[1] CHEN Xuan;ZHOU Min;ZHAO Jinwen(Department of Nephrology,Huaian First Hospital Affiliated to Nanjing Medical University,Huaian,Jiangsu Province,223300 China)

机构地区：[1]南京医科大学附属淮安第一医院肾内科,江苏淮安223300

出　　处：《系统医学》2022年第18期91-94,103,共5页Systems Medicine

摘　　要：目的观察复方α-酮酸在腹膜透析(PD)营养不良患者中的应用价值,并探索其作用机制。方法采用随机数表法将2020年4月—2021年4月南京医科大学附属淮安第一医院收治的PD营养不良患者分为两组,每组43例。对照组接受常规治疗联合低蛋白饮食,观察组在对照组基础上加用复方α-酮酸片。比较治疗前和治疗3个月患者炎性因子、肾功能、营养状态指标水平,评估临床疗效。结果治疗3个月,两组患者超敏-C反应蛋白(hs-CRP)、肿瘤坏死细胞-α(TNF-α)和白细胞介素-6(IL-6)、尿素氮(BUN)、血尿酸(UA)和血肌酐(Scr)指标下降,差异有统计学意义(P<0.05),且观察组hs-CRP、TNF-α、IL-6、BUN、UA和Scr水平较对照组显著降低,差异有统计学意义(P<0.05)。治疗3个月,两组患者白蛋白(ALB)、前蛋白(PA)、血红蛋白(Hb)和转铁蛋白(TRF)指标升高,差异有统计学意义(P<0.05),与对照组相比,观察组ALB、PA、Hb及TRF指标显著提高,差异有统计学意义(P<0.05)。观察组治疗总有效率95.35%高于对照组的76.74%,差异有统计学意义(χ^(2)=6.198,P<0.05)。结论复方α-酮酸能有效控制PD营养不良患者微炎症,改善肾功能和营养状况,疗效满意。Objective To observe the application value of compoundα-keto acid in malnutrition patients on peritoneal dialysis(PD),and to explore its mechanism of action.Methods The patients with PD malnutrition admitted to Huai′an First Hospital Affiliated to Nanjing Medical University from April 2020 to April 2021 were divided into two groups with 43 cases in each group by random number table method.The control group received conventional treatment combined with low-protein diet,the observation group was given compoundα-ketoacid tablets on the basis of the control group.The levels of inflammatory factors,renal function and nutritional status were compared before treatment and after 3 months of treatment,and the clinical efficacy was evaluated.Results After 3 months of treatment,high-sensitivity-C-reactive protein(hs-CRP),tumor necrosis cell-α(TNF-α)and interleukin-6(IL-6),blood urea nitrogen(BUN),serum uric acid(UA),and serum creatinine(Scr)indexes decreased,and the difference was statistically significant(P<0.05),and the levels of hs-CRP,TNF-α,IL-6,BUN,UA and Scr in the observation group were significantly lower than those in the control group,and the differences were as follows,the difference was statistically significant(P<0.05).After 3 months of treatment,the indexes of albumin(ALB),preprotein(PA),hemoglobin(Hb)and transferrin(TRF)in the two groups were increased,and the difference was statistically significant(P<0.05),which was significantly higher than that in the control group.Compared with the observation group,the ALB,PA,Hb and TRF indexes of the observation group were significantly improved,and the difference was statistically significant(P<0.05).The total effective rate of the observation group was 95.35%higher than that of the control group,76.74%,and the difference was statistically significant(χ^(2)=6.200,P<0.05).Conclusion Compoundα-ketoacid can effectively control micro-inflammation,improve renal function and nutritional status in patients with PD malnutrition,and the curative effect is satisfactory

关 键 词：复方Α-酮酸 腹膜透析 营养不良 机制 

分 类 号：R459.5[医药卫生—治疗学]