肝硬化患者蛋白质-能量营养不良(PEM)的营养支持治疗

Nutritional support treatment of protein energy malnutrition of patients with hepatocirrhosis

目的观察以植物蛋白为主的混合蛋白饮食对肝硬化患者蛋白质能量营养不良的营养支持作用。方法选择有蛋白质能量营养不良的乙肝肝硬化患者60例,其中观察组30例,给予以植物蛋白为主的高蛋白、高热量食谱;对照组30例给予医院常规食谱,分别于治疗前、治疗4周后观察两组患者血清白蛋白、转铁蛋白(transferrin,TRF)、上臂肌围、体重指数和肌酐身高指数等营养评价指标的变化。结果与治疗前相比,观察组和对照组各项指标均有显著改善。观察组血清白蛋白和转铁蛋白明显上升,与对照组相比有显著差异(P<0.05),两组的体重指数均有所上升,观察组上升较为明显,但无统计学差异(P>0.05),观察组的上臂肌围和肌酐身高指数明显优于对照组(P<0.05)。结论高蛋白营养支持饮食有利于改善肝炎后肝硬化患者的蛋白能量营养不良状态。

Objective To investigate the role of nutritional support of plant protein-based mixed-protein diet on protein energy malnutrition of patients with cirrhosis.Methods Sixty cases of protein energy malnutrition of hepatitis B patients with cirrhosis were divided into two groups.Observer group（30 cases） were given high protein,high calorie diet with plant protein-based.Control group（30 cases） were given routine hospital diet.The changes of nutritional evaluation indications of serum albumin,transferrin（TRF）,upper arm muscle circumference,body mass index and creatinine height index were observed pre-treatment and after treatment of four weeks.Results All indications of two groups showed a marked improvment.Albumin and transferrin in observer group increased significantly than those in control group（P〈0.05）.The change of body mass index in the two groups had no statistical difference（P〉0.05）.Upper arm muscle circumference and creatinine height index in observer group was higher than control group（P〈0.05）.Conclusion High-protein nutrition diet could improve protein energy malnutrition of liver cirrhosis.