肾病型肠内营养制剂在维持性血液透析并发营养不良病人中的疗效分析

Evaluation on effects of nephropathy type enteral nutrition agent in patients with maintenance hemodialysis and malnutrition

目的：观察肾病型肠内营养（EN）制剂在改善维持性血液透析（MHD）并发营养不良病人营养状态的有效性。方法：选取MHD并发营养不良的病人80例，随机分为观察组和对照组。病人在常规血液透析基础上（2—3次／周），观察组应用。肾病型EN制剂治疗6个月，对照组给予单纯饮食指导。分别于营养治疗开始、3个月和结束时观察两组病人的主观综合营养评估（SGA），人体成分分析指标（体重、肌肉、蛋白质、脂肪、水分和BMI），生化指标（血清清蛋白、前清蛋白、肌酐、尿素）和透析充分性指标尿素清除率（Kt／V）等。结果：病人营养治疗后SGA、体重、肌肉、蛋白质、脂肪、水分、BMI、清蛋白、前清蛋白较治疗前明显升高（P〈0．05）；血肌酐、尿素和Kt／V治疗前后无显著性差异（P〉0．05）。观察组病人SGA、体重、肌肉、蛋白质、脂肪、BMI、清蛋白和前清蛋白较对照组升高，两组问比较有显著性差异（P〈0．05）；而血肌酐、尿素、水分和Kt／V无显著性差异（P〉0．05）。结论：肾病型肠内营养制剂可有效地改善维持性血液透析合并营养不良病人的营养状况。

Objective ： To observe the effectiveness of nephropathy type enteral nutrition agent in improving nutritional status in patients with maintenance hemodialysis （MHD） and Malnutrition. Methods： 80 patients with malnutrition and MHD were selected On the basis of conventional hemodialysis and randomly divided into observation group and control group. The observation group patients received 6 months of nephropathy type enteral nutrition agent treatment. The control group received simple diet guidance. The subjective comprehensive nutrition evaluation（SGA）, human body measurements, BMI, biochemical indicator, and Kt/V of two groups were detected at the beginning of treatment and in 3 months, 6 months treatment respectively. Results： Compared with pretreatment, SGA, human body measurements, serum albumin and prealbumin were significantly elevated （P 〈 0.05 ） , and serum creatinine, blood urea nitrogen and Kt/V had no statistically significant difference （ P 〉 0. 05 ）. Weight, Muscle, Protein, Fat, Body mass index （ BMI）, serum albumin, serum prealbumin of observation group were significantly higher than the control group （ P 〈 0.05 ）. The serum crcatinine, blood urea nitrogen and Kt/V of two groups had no significant difference （ P 〉 0.05 ）. Conclusion ： Nephropathy type enteral nutrition agent can effectively improve the nutritional status of maintenance hemodialysis.