α-酮酸配伍低蛋白饮食对长期腹膜透析患者肾功能及营养状况的影响

The effect of α-keto acid low-protein diet for long-term peritoneal dialysis on renal function,calcium and phosphorus metabolism and ADA levels in patients with malnutrition

目的探讨α-酮酸配伍低蛋白饮食对长期腹膜透患者肾脏功能、钙磷代谢、腺苷脱氨酶(ADA)活性及营养不良发生率的影响。方法选取长期接受腹膜透析的患者90例,随机分为观察组和对照组,每组各45例。两者患者均接受临床常规治疗,其中对照组给予低蛋白饮食[0.8 g/(kg·d)],观察组患者接受α-酮酸配伍低蛋白饮食,两组患者均持续治疗3个月,分别于治疗前后对比分析两组患者的肾脏功能、血清钙磷水平、ADA活性的变化,观察治疗3个月后两组营养不良发生率。结果治疗前,两组各观察指标无显著差异(P>0.05)。治疗后,两组各观察指标均显著改善(P<0.01)。观察组治疗后血清肌酐、尿素氮、尿酸、血磷水平及ADA活性明显低于对照组;血钙水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗3个月后,观察组营养不良发生率明显低于对照组(P<0.05)。结论α-酮酸配伍低蛋白饮食对于长期进行腹膜透析得患者具有显著的临床疗效,能够改善患者钙磷代谢紊乱和营养状态,同时降低患者的ADA活性,在临床治疗长期腹膜透析患者中具有重要意义。

Objective To explore the effect of α-keto acid and low-protein diet on renal function in patients with peritoneal dialysis,calcium and phosphorus metabolism,adenosine deaminase（ADA） activity and the incidence of malnutrition.Methods In 90 patients receiving chronic peritoneal dialysis in this hospital were randomly divided into observation group and control group,each with 45 cases.Patients in both groups were underwent routine clinical treatment,patients in control group received low-protein diet [0.8 g/（kg·d） ],patients in observation group received α-keto acid and low-protein diet,the treatment of patients in these 2 groups had been continued for 3 months,respectively.The renal function,serum levels of calcium and phosphorus and the activity of adenosine deaminase（adenosine deaminase,ADA） in these two groups of patients after treatment were compared before and after treatment.Results Before treatment,the difference was not significant between these two groups（P〉0.05）.After treatment,patients in these two groups were significantly improved（P〈0.01）.The serum levels of creatinine,urea nitrogen,uric acid,serum phosphorus and ADA activity in observation group were significantly lower than those of control group;the levels of serum calcium were significantly higher than those in control group,and the difference was statistically significant（P〈0.05）.Conclusion The application of α-keto acid and low-protein diet in patients with long-term peritoneal dialysis has significant clinical effect,it can improve the disorder in calcium and phosphorus metabolism and nutritional status of patients,and reduce the activity of adenosine deaminase,hence it has important clinical significance in patients with chronic peritoneal dialysis.