低钠低磷型蛋白质制剂改善慢性肾功能衰竭患者营养状况的效果

Effect of Protein Formula with Lower Natrium and Lower Phosphorum on Patients with Chronic Renal Failure

目的用低钠低磷型蛋白质制剂作为蛋白质补充营养制剂,观察其对慢性肾功能衰竭患者营养改善的效果。方法 60例接受透析治疗的慢性肾功能衰竭患者,平均年龄(48.3±17.4)岁；随机分为试验组和对照组,每组30例。试验组每天按0.8 g／kg补充低钠低磷型蛋白质制剂,共14天,对照组为正常饮食。在试验前、后分别检测营养相关的指标。结果根据身高和体重进行营养评价,试验开始前试验组53.5％,对照组54.7％的患者存在营养不良,14天后体重与试验前相比,虽有所改善,但无显著性差异；体重、上臂肌围、三头肌皮褶厚度在试验前后变化均不明显,无显著性差异(P＞0.05)；血红蛋白(Hb)有所升高,但无统计学意义(P＞0.05)。与对照组相比,试验组血清ALB(白蛋白)、PA(前白蛋白)均有升高,与对照组相比均有显著性差异分别(P＜0.05和P＜0.01)。试验后试验组血清磷与对照组比较有显著性差异(P＜0.05)。试验组和对照组血清尿素氮、肌酐在试验后,均降低非常显著(P＜0.01)。试验前患者血清氨基酸,特别是必需氨基酸和组氨酸含量明显降低(P＜0.05),用低钠低磷型蛋白质制剂后血清氨基酸谱有所变化,支链氨基酸——亮氨酸、异亮氨酸和缬氨酸含量明显增高(P＜0.01),苏氨酸、酪氨酸、组氨酸也有所升高(P＜0.05),其余氨基酸血清含量无明显改变。结论低钠低磷型蛋白质制剂对慢性肾功能衰竭患者有明显的改善蛋白质营养状况的效果。

To study the effect of Shengjia, a specialized protein formula with lower natrium and lower phosphorum, in patients with chronic renal failure （CRF）. Methods A prospective, randomized, and double-blind clinical trial was performed. Sixty patients who were receiving dialysis with an average age of （48.3 ± 17.4） years, were randomly divided into the therapy group （receiving Shengjia 0.8 kg/d） and the control group （receiving normal diet）. The index related to nutrition were monitored before and after study. Result All patients completed the whole study course without obvious adverse events. Before study, malnutrition existed in 53.5% of patients in the therapy group and in 54.7% patients in the control group. After study, both groups were improved but not significant. Before and after study, weigh, mid-arm muscle circumference （MAMC）, and triceps skin fold thickness （TSF） had no significant changes between these two groups （P 〉 0.05）. Compared with the control group, ALB and PA except Hb in the therapy group were significantly increased （P 〈 0.05）. Bun, Ccr in two group were significantly decreased after study （P 〈 0.01）. Before study, all patients had poor essential amino acid and histidine profile. After study, branched-chain amino acid, including leucine, isoleucine, and valine increased remarkably （P〈 0.01）, and threonine, tyrosine, and histidine also significantly increased too （P 〈 0.05）, while other amino acids had no significant changes. Conclusion The specialized protein formula with lower natrium and lower phosphorum can greatly improve the protein level in CRF patients.