中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
12期
10-11,13
,共3页
李燕%刘明龙%卢守燕%刘天喜%李建华
李燕%劉明龍%盧守燕%劉天喜%李建華
리연%류명룡%로수연%류천희%리건화
低蛋白饮食%α-酮酸%慢性肾脏病%结肠透析
低蛋白飲食%α-酮痠%慢性腎髒病%結腸透析
저단백음식%α-동산%만성신장병%결장투석
Low protein diet%Alpha keto acid%Chronic renal failure%Colon dialysis
目的：观察α-酮酸配伍低蛋白饮食对结肠透析患者营养状况及残余肾功能(RRF)的影响。方法：随访兰州大学第一医院肾病科结肠透析中心结肠透析患者48例1年，随机分为α-酮酸配伍低蛋白饮食组(酮酸组，18例)、低蛋白组(15例)、常规蛋白组(15例)。检测治疗前、后血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)、视黄醇结合蛋白(RBP)、胆固醇(TC)、甘油三酯(TG)、肱三头肌处皮褶厚度(TSF)、上臂肌围(MAMC)和体重指数(BMI)营养状态指标，动态观察残存肾功能(RRF)、肌酐清除率(Ccr)及残存尿量的变化，并进行血清氨基酸谱的测定。结果：比较3组的营养指标，酮酸组、常规蛋白组均显著高于低蛋白组，P＜0.05差异有统计学意义；其中酮酸组的 BMI、TSF、MAMC、Alb、TC 及 TG 均高于常规蛋白组，但 P＞0.05差异无统计学意义；比较3组的缬氨酸(Val)、亮氨酸(Leu)、异亮氨酸(Ile)水平，酮酸组均高于低蛋白组及常规蛋白组，P＜0.05差异有统计学意义；比较3组的 Ccr、RRF、残存尿量，酮酸组与低蛋白组的均高于常规蛋白组，P＜0.05差异有统计学意义。结论：α-酮酸配伍低蛋白饮食对结肠透析患者的营养不良具有一定的改善作用，且能够起到保护 RRF 的作用，并能使血浆支链氨基酸(BCAA)水平显著提高。
目的：觀察α-酮痠配伍低蛋白飲食對結腸透析患者營養狀況及殘餘腎功能(RRF)的影響。方法：隨訪蘭州大學第一醫院腎病科結腸透析中心結腸透析患者48例1年，隨機分為α-酮痠配伍低蛋白飲食組(酮痠組，18例)、低蛋白組(15例)、常規蛋白組(15例)。檢測治療前、後血清白蛋白(Alb)、前白蛋白(PA)、轉鐵蛋白(TRF)、視黃醇結閤蛋白(RBP)、膽固醇(TC)、甘油三酯(TG)、肱三頭肌處皮褶厚度(TSF)、上臂肌圍(MAMC)和體重指數(BMI)營養狀態指標，動態觀察殘存腎功能(RRF)、肌酐清除率(Ccr)及殘存尿量的變化，併進行血清氨基痠譜的測定。結果：比較3組的營養指標，酮痠組、常規蛋白組均顯著高于低蛋白組，P＜0.05差異有統計學意義；其中酮痠組的 BMI、TSF、MAMC、Alb、TC 及 TG 均高于常規蛋白組，但 P＞0.05差異無統計學意義；比較3組的纈氨痠(Val)、亮氨痠(Leu)、異亮氨痠(Ile)水平，酮痠組均高于低蛋白組及常規蛋白組，P＜0.05差異有統計學意義；比較3組的 Ccr、RRF、殘存尿量，酮痠組與低蛋白組的均高于常規蛋白組，P＜0.05差異有統計學意義。結論：α-酮痠配伍低蛋白飲食對結腸透析患者的營養不良具有一定的改善作用，且能夠起到保護 RRF 的作用，併能使血漿支鏈氨基痠(BCAA)水平顯著提高。
목적：관찰α-동산배오저단백음식대결장투석환자영양상황급잔여신공능(RRF)적영향。방법：수방란주대학제일의원신병과결장투석중심결장투석환자48례1년，수궤분위α-동산배오저단백음식조(동산조，18례)、저단백조(15례)、상규단백조(15례)。검측치료전、후혈청백단백(Alb)、전백단백(PA)、전철단백(TRF)、시황순결합단백(RBP)、담고순(TC)、감유삼지(TG)、굉삼두기처피습후도(TSF)、상비기위(MAMC)화체중지수(BMI)영양상태지표，동태관찰잔존신공능(RRF)、기항청제솔(Ccr)급잔존뇨량적변화，병진행혈청안기산보적측정。결과：비교3조적영양지표，동산조、상규단백조균현저고우저단백조，P＜0.05차이유통계학의의；기중동산조적 BMI、TSF、MAMC、Alb、TC 급 TG 균고우상규단백조，단 P＞0.05차이무통계학의의；비교3조적힐안산(Val)、량안산(Leu)、이량안산(Ile)수평，동산조균고우저단백조급상규단백조，P＜0.05차이유통계학의의；비교3조적 Ccr、RRF、잔존뇨량，동산조여저단백조적균고우상규단백조，P＜0.05차이유통계학의의。결론：α-동산배오저단백음식대결장투석환자적영양불량구유일정적개선작용，차능구기도보호 RRF 적작용，병능사혈장지련안기산(BCAA)수평현저제고。
Objective:To observe the effect of alpha keto acid combined with low protein diet on the nutritional status and residual renal function(RRF) of patients with colon dialysis.Methods:48 patients with colon dialysis of the colon dialysis centers of the de-partment of nephropathy of first hospital affiliated to Lanzhou university were followed up for 1 year.They were randomly divided into alpha keto acid combined with low protein diet group(keto group,18 cases),low protein group(15 cases),and conventional pro-tein group(15 cases),we detected serum albumin(Alb),pre albumin(PA),transferrin(TRF),retinol binding protein(RBP),cholester-ol(TC),triglyceride(TG),triceps skinfold thickness(TSF),arm muscle circumference(MAMC)and body mass index(BMI) nutrition state index before and after treatment.We had dynamic observation of the chang of residual renal function(RRF),creatinine clear-ance rate(Ccr)and residual urine volume and measured serum amino acid spectrum .Results:Nutritional indexes of the three groups were compared,keto group and conventional protein group were significantly higher than that of low protein group.The dif-ference had statistical significance(P<0.05);BMI,TSF,MAMC,Alb,TC and TG of the keto group were higher than those of the con-ventional protein group,but the difference was not significant (P>0.05);valine(Val),leucine(Leu),isoleucine(Ile)level of the three groups were compared,keto group were higher than that of low protein group and conventional protein group,the difference has sta-tistical significance (P<0.05);Ccr,RRF,residual urine volume of the three groups were compared,keto group and low protein group were higher than those of conventional protein group,the difference had statistical significance(P<0.05).Conclusion:Alpha keto acid combined with low protein diet has a certain effect on malnutrition of patients with colon dialysis,play a role in the pro-tection of RRF,can significantly improve the plasma levels of branched chain amino acid(BCAA).
