中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
Chinese Journal of Clinical Nutrition
2015年
5期
282-286
,共5页
腹膜透析%体成分分析%四肢肌肉量%膳食管理
腹膜透析%體成分分析%四肢肌肉量%膳食管理
복막투석%체성분분석%사지기육량%선식관리
Peritoneal dialysis%Body composition analysis%Appendicular skeletal muscle%Dietary intake management
目的 探讨腹膜透析患者四肢肌肉量变化情况,分析四肢肌肉量变化与膳食摄入的关系.方法 采用便利抽样方法选择北京大学第三医院肾内科腹膜透析患者114例,在基线、透析后6及12个月采用多频体成分测量仪测评患者的体质量、总肌肉量、四肢肌肉量情况,用3天饮食记录法测评其膳食摄入情况,同时收集患者基线时人口社会学资料及临床资料.结果 透析后12个月的四肢肌肉量比基线时明显减少,差异有统计学意义[(19.27±5.59) kg比(25.65±6.09) kg,P=0.000];蛋白质摄入显著减少,差异有统计学意义[(0.85±0.21) g/(kg·d)比(0.90±0.27) g/(kg·d),P=0.038];能量摄入显著减少,差异有统计学意义[(128.37±26.67) kJ/(kg·d)比(137.27±29.23)kJ/(kg·d),P=0.001].将四肢肌肉量变化量进行3等分,肌肉减少量前1/3组患者的平均蛋白质摄入量(0.82±0.18) g/(kg·d)显著低于肌肉减少量后1/3组的患者(0.91 ±0.20) g/(kg·d)(P=0.021).结论 随着腹透治疗的进行,患者四肢肌肉量减少,主要与其蛋白质、能量摄入不足有关,应加强透析患者的膳食管理,以缓解患者四肢肌肉量的衰减.
目的 探討腹膜透析患者四肢肌肉量變化情況,分析四肢肌肉量變化與膳食攝入的關繫.方法 採用便利抽樣方法選擇北京大學第三醫院腎內科腹膜透析患者114例,在基線、透析後6及12箇月採用多頻體成分測量儀測評患者的體質量、總肌肉量、四肢肌肉量情況,用3天飲食記錄法測評其膳食攝入情況,同時收集患者基線時人口社會學資料及臨床資料.結果 透析後12箇月的四肢肌肉量比基線時明顯減少,差異有統計學意義[(19.27±5.59) kg比(25.65±6.09) kg,P=0.000];蛋白質攝入顯著減少,差異有統計學意義[(0.85±0.21) g/(kg·d)比(0.90±0.27) g/(kg·d),P=0.038];能量攝入顯著減少,差異有統計學意義[(128.37±26.67) kJ/(kg·d)比(137.27±29.23)kJ/(kg·d),P=0.001].將四肢肌肉量變化量進行3等分,肌肉減少量前1/3組患者的平均蛋白質攝入量(0.82±0.18) g/(kg·d)顯著低于肌肉減少量後1/3組的患者(0.91 ±0.20) g/(kg·d)(P=0.021).結論 隨著腹透治療的進行,患者四肢肌肉量減少,主要與其蛋白質、能量攝入不足有關,應加彊透析患者的膳食管理,以緩解患者四肢肌肉量的衰減.
목적 탐토복막투석환자사지기육량변화정황,분석사지기육량변화여선식섭입적관계.방법 채용편리추양방법선택북경대학제삼의원신내과복막투석환자114례,재기선、투석후6급12개월채용다빈체성분측량의측평환자적체질량、총기육량、사지기육량정황,용3천음식기록법측평기선식섭입정황,동시수집환자기선시인구사회학자료급림상자료.결과 투석후12개월적사지기육량비기선시명현감소,차이유통계학의의[(19.27±5.59) kg비(25.65±6.09) kg,P=0.000];단백질섭입현저감소,차이유통계학의의[(0.85±0.21) g/(kg·d)비(0.90±0.27) g/(kg·d),P=0.038];능량섭입현저감소,차이유통계학의의[(128.37±26.67) kJ/(kg·d)비(137.27±29.23)kJ/(kg·d),P=0.001].장사지기육량변화량진행3등분,기육감소량전1/3조환자적평균단백질섭입량(0.82±0.18) g/(kg·d)현저저우기육감소량후1/3조적환자(0.91 ±0.20) g/(kg·d)(P=0.021).결론 수착복투치료적진행,환자사지기육량감소,주요여기단백질、능량섭입불족유관,응가강투석환자적선식관리,이완해환자사지기육량적쇠감.
Objective To explore the changes of appendicular skeletal muscle (ASM) in peritoneal dialysis (PD) patients, and to analyze the relationship between ASM changes and dietary intake.Methods One hundred and fourteen PD patients were enrolled in Department of Nephrology, Peking University Third Hospital using convenience sampling.At baseline, and 6 and 12 months after PD, bioelectrical impedance analysis was used to assess the body weight, total muscle mass, and ASM of these patients, and three-day food record was used to assess the dietary intake.Demographics and clinical data were also collected at baseline.Results Compared with baseline, the patients' ASM at 12 months after PD decreased significantly [(19.27 ± 5.59) kg vs.(25.65 ±6.09) kg, P =0.000], the dietary protein intake and energy intake decreased significantly [(0.85 ± 0.21) g/(kg · d) vs.(0.90 ± 0.27) g/(kg · d), P =0.038;(128.37 ± 26.67) kJ/(kg· d)vs.(137.27 ±29.23) kJ/(kg· d), P=0.001].The patients were divided into three groups based on ASM loss, the mean dietary protein intake of the top-loss 1/3 group was statistically lower than that of the bottom-loss 1/3 group [(0.82 ± 0.18) g/(kg · d) vs.(0.91 ± 0.20) g/(kg · d), P =0.021].Conclusions With the continuation of PD, ASM of patients may decrease, which is likely to be mainly related to deficiency in protein and energy intakes.Dietary management should be strengthened in PD patients to alleviate the loss of ASM.
