甲氧氯普胺加入腹透液中对腹膜透析患者食欲及营养状况的影响

The Effect of Metoclopramide on Appetite and Nutritional Status in Peritoneal Dialysis Patients

目的:探讨甲氧氯普胺加入腹透液中对腹膜透析患者食欲及营养状况的影响。方法:将食欲明显减退的腹膜透析患者为研究对象,随机分成观察组52例和对照组52例,两组常规治疗相同,观察组予甲氧氯普胺注射液10 mg/d加入腹透液中,疗程为4周。比较两组治疗前和治疗后3月的食欲和血白蛋白、体重指数(BMI)、中臂围、中臂肌围、肱三头肌皮褶厚度(TSF)、改良定量主观整体评估(MQSGA)等营养指标的差别。结果:(1)观察组总有效率(90.39%)显著高于对照组(69.23%),差异有统计学意义(P<0.05);(2)观察组治疗后白蛋白、BMI、中臂围、中臂肌围和TSF均较治疗前显著升高,MQSGA较治疗前显著下降,差异均有统计学意义(P<0.05);对照组治疗后白蛋白较治疗前显著升高,MQSGA较治疗前显著下降,差异均有统计学意义(P<0.05);治疗后,观察组白蛋白显著高于对照组,MQSGA显著低于对照组,差异均有统计学意义(P<0.05);(3)两组均未见明显药物不良反应。结论:甲氧氯普胺加入腹透液中可改善腹膜透析患者食欲和营养状况。

Objective：To explore the effect of metoclopramide on appetite and nutritional status in peritoneal dialysis pa-tients. Methods：104 peritoneal dialysis patients were randomly divided into the observe group（ n=52 ）and the control group（ n=52 ）. They all accepted the conventional treatment,but the patients in the observed group were given the treatment of metoclopramide injection（10 mg/d）by inpouring abdominal cavity for four weeks. The difference of the appetite,serum albumin,body mass index （ BMI）,mid-arm circumference,mid-arm muscle circumference,triceps skinfold thickness（ TSF）,modified quantitative subjec-tive global assessment（MQSGA）were compared between the two group after treatment of 3 months. Results：（1）Total effective rate in the observe group（90. 39%）was significantly higher than that in the control group（69. 23%）（P〈0. 05）;（2）In the observa-tion group,the serum albumin,BMI,mid-arm circumference,mid-arm muscle circumference and TSF after treatment were signifi-cantly higher than that before treatment（P〈0. 05）,and the MQSGA after treatment were significantly lower than that before treat-ment（P〈0. 05）;In the control group,the serum albumin after treatment were significantly higher than that before treatment（P〈0. 05）,and the MQSGA after treatment were significantly lower than that before treatment（P〈0. 05）;after treatment,serum albu-min in the observe group was significantly higher than that in the control group（P〈0. 05）,and the MQSGA in the observe group was significantly lower than that in the control group（P〈0. 05）.（3）There’s no obvious adverse drug reaction in the two groups. Con-clusion：Metoclopramide could improve appetite and nutritional status for peritoneal dialysis patients.