糖尿病肾病患者营养治疗观察

A Observation of Nutritional Therapy on Patients of Diabetic Nephropathy

目的:探讨低蛋白饮食辅助α-酮酸延缓糖尿病肾病患者肾功能恶化的作用。方法:将肾功能处于失代偿期的糖尿病肾病患者分为单纯低蛋白饮食组(对照组)和低蛋白饮食辅助α-酮酸(试验组),在常规治疗的基础上,试验组给予优质蛋白0．6 g/(kg·d),并同时补充α-酮酸0．1 g/(kg·d)。对照组只给予优质蛋白0．7g/(kg·d),两组患者热量的摄入量均为30～35 kcal/(kg·d),动态观察两组患者肾功、营养状况、血脂、血糖的变化。结果:试验组患者肾功能恶化延缓,血脂、血糖、尿蛋白降低,差异有统计学意义(P＜0．05～0．01),营养状态无明显受损。结论:低蛋白饮食辅助复方α-酮酸制剂具有减轻氮质血症,改善糖、脂、蛋白质代谢,减少尿蛋白排泄,延缓糖尿病肾病患者肾功恶化的作用。

Objective：To investigate the effect of α - ketoacid supplemented low - protein diet therapy on delaying chronic renal failure of patients with diabetic nephropathies. Method： 36 patients who were assigned to a low - protein diet supplemented with α - ketoacid group（test group, 21 patients） and low- protein diet group （control group, 15 patients）. Based on the conventional therapy, patients in test group performed α - ketoaeid supplemented low- protein diet： hign quality protein 0.6 g/（ks · d ） supplemented a - ketoacid 0.1 g/（kg · d）, patients in control group only performed low protein diet： high quality protein 0.7 g/（kg · d） .The dietary caloric intake were 30- 35 kcal/（kg · d） . The change of renal function, nutritional state, serum glucose, lipids and urinary protein were measured every month. Results： There were significant difference in renal function, serum glucose, lipids and urinary protein between two groups （ P 〈 0.05 - 0.01）. While patients in test group maintaining good nutritional state. Conclusion： α - ketoacid supple- mented low - protein diet therapy may help to reduce azotemia, improve the carbohydrate, lipids and protein metabolism, decrease the urinary protein, delay the deterioration of renal function.