乳清蛋白全营养剂在低蛋白血症患者中的应用

Application of Lactalbumin Enriched Enteral Nutrition in Hypoproteinemia Patients

目的观察乳清蛋白在改善老年低蛋白血症患者营养状况及胃肠道耐受性。方法对28例低蛋白血症老年患者采取自身对照法,按先前能量蛋白质摄取量的不同及喂饲途径不同分A、B两组,给予部分或全部乳清蛋白全营养剂,比较A、B两组服用乳清蛋白全营养剂前后的身体测量数据,营养状况指标,肝、肾功能以及腹部症状的变化。结果A、B两组血红蛋白、总蛋白、白蛋白服用前后差异有显著性(P<0.05),而两组肝、肾功能及其它生化指标服用前后差异无显著性,其中,A组的转铁蛋白,体重,B组的上臂围营养指标也有差异(P<0.05),A组IgM有明显变化,两组的胃肠道症状服用前后亦有改变。结论老年低蛋白血症患者营养状况的改善需同时保证摄入蛋白质的量和质,但又不能过量,过量则会损害老年人的肝、肾功能,故高生物利用率的乳清蛋白被作为酪蛋白之后的第二代氮源产品推出,它能弥补老年人对酪蛋白因消化吸收不良而导致的缺乏,使营养状况在较短的时间里得以改善。此外,必须保证足够的热能摄入,否则,蛋白质作为供能营养素就失去了其本身的意义。

Objective To observe the efficacy and intestinal tolerance of lactalbumin in improving the nutritional status of the elderly hypoproteinemia patients.Methods Twenty eight elderly hypoproteinemia patients,take their per-study condition as self control groups,were divided into group A and B according to the different amount and route of energy and protein intake prior to the study.Loactalbumin enriched enteral nutrition was given in part or full to each group.Anthropometris data,parameters of nutritional status,hepatic and renal function and variation of abdominal symptoms before and after the study were compared with paired t test.Results There were significant differences in hemoglobulin total protein and albumin between group A and B(P<0.05),but no such differences in hepatic and renal function and other biochemical indices.Differences also existed in transferring and body weight in group A,nutrition index of upper arm in group B(P<0.05),IgM in group A and symptoms of digestive tract in both groups.Conclusions It was necessary to ensure both quantity and quality of protein intake for improving nutritional status of the elderly hypoproteinemia patients,but overtaking which harms hepatic and renal function of the elderly people should be avoided.Lactalbumin,as second generation of nitrogen providing product after casein,has high biologic utilizing rate.It can amend protein deficiency in elderly people due to their maldigestion and malabsorption of casein and improve their nutritional status in rather short time. Besides,enough calorie intake must be guaranteed,otherwise protein will be consumed as energy and lost its intended value.