腹膜透析患者蛋白质摄入水平与其营养状况及炎症水平的相关性分析

Correlation Analysis of CAPD Patients' Protein Intake Levels and Their Nutritional Status and Inflammation Levels

目的：探讨持续性腹膜透析（Continuous ambulatory peritoneal dialysis,CAPD）患者蛋白质摄入情况与其营养状况及炎症水平的相关性。方法：CAPD患者31例,规律透析4~70个月,采用三日饮食记录法记录患者饮食情况,计算患者每日蛋白质、脂肪、碳水化合物及能量摄入水平,根据患者蛋白质摄入情况将其分为低、中、高3组[DPI分别为〈0.8g/（kg·d）、0.8~1.2g/（kg·d）、〉1.2g/（kg·d）]。测定3组患者血红蛋白（HGB）、总蛋白（TP）、白蛋白（ALB）、前白蛋白（PA）、超敏C反应蛋白（hs-CRP）水平,比较3组间各项指标的差异。结果：3组间比较,DPI低等组和DPI中等组,HGB水平高于DPI高等组,差异具有统计学意义（P值分别为0.42和0.32）;DPI中等组TP、ALB、PA的水平高于其他2组,其中DPI中等组与DPI高等组之间的差异具有统计学意义（P=0.28）。DIP中等组,hs-CRP水平低于其他两组,其中DPI中等组和DPI高等组之间的差异具有统计学意义（P=0.23）。结论：腹膜透析患者蛋白质的摄入水平与其营养状态及体内的炎症水平密切相关。摄入适量的蛋白质[DPI=0.8~1.2g/（kg·d）]有利于其营养状态及炎症水平的控制。DPI过低,患者营养不良的发生风险也会增高。DPI过高,患者的透析充分性较差,体内氮质血症较严重,影响其营养状态,其体内的炎症水平也会增加。

Objective To investigate the correlation of continuous ambulatory peritoneal dialysis（ CAPD） patients’ protein intake levels and their nutrition status and inflammation levels. Method Dialysis time of 31 CAPD patients is from 4 to 70 months. We recorded diet content for three days,calculated their daily protein,fat,carbohydrate and energy intake levels. According to the protein intake levels,the patients were divided into three groups including low DPI group [DPI 〈 0. 8g /（ kg·d）],middle DPI group [DPI： 0. 8 ~ 1. 2g /（ kg·d）and high DPI group [DPI 〉 1. 2g /（ kg·d）]. Then we detected the levels of HGB,TP,ALB,PA,hs-CRP of the patients,and compared their differences among the three groups. Result Low DPI group and middle DPI group’s HGB levels were higher than high DPI group（P =0. 42 and 0. 32）. Middle DPI group’s PA level was higher than high DPI group（P =0. 28）. DPI middle group’s hs-CPR level was lower than high DPI group（ P = 0. 23）. Conclusion Appropriate protein intake [DPI 0. 8 ~ 1. 2g /（ kg·d） could improve nutritional status and reduce the inflammation levels of CAPD patients. Low DPI level [DPI 〈 0. 8g /（ kg·d） led to high risk of malnutrition. High DPI level [DPI 〉 1. 2g /（ kg·d）] could aggravate nitremia,make their nutritional status more serious,and increase the level of inflammation of the patients.