CAJ | 학술논문

目的：探讨低蛋白饮食治疗维持性血液透析（MHD）患者高磷血症的有效性与安全性。方法选取2012年10月-2013年8月中国人民解放军空军总医院血液净化中心行 MHD 的高磷血症患者28例，采用随机数字表法分为低蛋白饮食组〔16例，每日蛋白摄入量（DPI）为0.8 g·kg -1·d -1〕、常规蛋白饮食组（12例，DPI 为1.2 g ·kg -1·d -1），治疗6个月。观察两组患者治疗前及治疗3、6个月时血清磷、血清矫正钙、钙磷乘积、全段甲状旁腺激素水平、营养状况及人体测量学指标变化。结果治疗前两组患者的血清磷水平、钙磷乘积差异均无统计学意义（P >0.05）；治疗3、6个月时，两组患者血清磷水平、钙磷乘积间差异均有统计学意义（P <0.05）。低蛋白饮食组患者治疗3、6个月时血清磷水平、钙磷乘积较治疗前降低，差异有统计学意义（ P <0.05），而常规蛋白饮食组患者血清磷水平及钙磷乘积治疗前后差异无统计学意义（P >0.05）。两组患者治疗前后清蛋白、前清蛋白、转铁蛋白、总胆固醇水平、营养不良-炎症评分及人体测量学指标间差异均无统计学意义（ P >0.05）。结论 DPI 为0.8 g·kg -1· d -1可降低我国 MHD 患者血清磷水平及钙磷乘积，且对营养状况无明显影响。
목적：탐토저단백음식치료유지성혈액투석（MHD）환자고린혈증적유효성여안전성。방법선취2012년10월-2013년8월중국인민해방군공군총의원혈액정화중심행 MHD 적고린혈증환자28례，채용수궤수자표법분위저단백음식조〔16례，매일단백섭입량（DPI）위0.8 g·kg -1·d -1〕、상규단백음식조（12례，DPI 위1.2 g ·kg -1·d -1），치료6개월。관찰량조환자치료전급치료3、6개월시혈청린、혈청교정개、개린승적、전단갑상방선격소수평、영양상황급인체측량학지표변화。결과치료전량조환자적혈청린수평、개린승적차이균무통계학의의（P >0.05）；치료3、6개월시，량조환자혈청린수평、개린승적간차이균유통계학의의（P <0.05）。저단백음식조환자치료3、6개월시혈청린수평、개린승적교치료전강저，차이유통계학의의（ P <0.05），이상규단백음식조환자혈청린수평급개린승적치료전후차이무통계학의의（P >0.05）。량조환자치료전후청단백、전청단백、전철단백、총담고순수평、영양불량-염증평분급인체측량학지표간차이균무통계학의의（ P >0.05）。결론 DPI 위0.8 g·kg -1· d -1가강저아국 MHD 환자혈청린수평급개린승적，차대영양상황무명현영향。
Objective To investigate the efficacy and safety of long - term use of low protein diet in treating hyper-phosphatemia patients having maintenance hemodialysis(MHD). Methods A total of 28 hyperphosphatemia patients having MHD at blood purificationf centre in Air Force General Hospital,PLA from October 2012 to August 2013 were randomized into groups A〔n = 16,diatary protein intake(DPI) = 0. 8 g·kg - 1 ·d - 1〕,B(n = 12,DPI = 1. 2 g·kg - 1 ·d - 1 ). The chan-ges of serum phosphorus,corrected calcium,phosphorus product,intact parathyroid hormone,nutritional status and anthropo-metric indicators were observed in 2 groups before and after treatment. Results There were no significant differences in serum phosphorus,calcium - phosphorus products between 2 groups before treatment( P > 0. 05). There were differences in serum phosphorus,calcium - phosphorus products 3,6 months after treatment(P < 0. 05),and lower in group A than in group B(P< 0. 05),but there was no difference between pre - and post - treatments in group B(P > 0. 05). There were no significant differences in albumin,prealbumin,transferrin,total cholesterol levels,malnutrition - inflammation score and anthropometric indicators between 2 groups before and after treatment(P > 0. 05). Conclusion DPI of 0. 8 g·kg - 1 ·d - 1 can reduce serum phosphorus and phosphorus product in Chinese MHD patients,not effecting nutritional status remarkably.