营养干预对肾衰竭维持性血液透析患者营养状况及钙磷代谢的影响

Effect of Nutritional Intervention on Nutritional Status and Calcium and Phosphorus Metabolism in Patients with Renal Failure and Undergoing Maintenance Hemodialysis

目的:探讨营养干预对肾衰竭维持性血液透析患者营养状况和钙磷代谢的影响。方法:选取100例2018年2月—2020年9月在我院进行维持性血液透析的肾衰竭患者,采用随机数字表法,将100例患者随机均分为观察组和对照组,两组患者间年龄、性别、原发疾病、已接受血液透析治疗时间均无差异(P>0.05),具有可比性。其中,对观察组患者实施为期3个月的营养干预,对照组进行常规临床治疗和护理。比较维持性血液透析前后两组营养状况和钙磷代谢的变化,以及透析后两组患者外周血营养指标和钙磷代谢的变化情况。结果:两组患者经维持性血液透析后,血清TP、ALB、PA、HGB水平均较透析前高,且透析后,营养干预组患者血清TP[(66.28±2.65)vs(63.26±2.84)g/L]、ALB[(33.96±1.14)vs(32.22±1.33)g/L]、PA[(206.58±13.90)vs(191.38±12.95)mg/L]及HGB[(99.56±3.20)vs(96.60±3.46)g/L]水平均高于对照组患者,差异有统计学意义(P<0.05)。经维持性血液透析后,两组患者血清血钙水平均较透析前高,血清血磷、钙磷乘积及iPTH水平均较透析前降低,且透析后,营养干预组患者血清血钙[(1.48±0.17)vs(1.19±0.18)mmol/L]显著高于对照组患者,血清血磷[(2.77±0.34)vs(3.67±0.25)mmol/L]、钙磷乘积[(4.06±0.59)vs(4.38±0.75)mmol2/L2]及iPTH[(260.30±53.72)vs(282.12±57.18)ng/L]水平均显著低于对照组患者,差异有统计学意义(P<0.05)。结论:营养干预可改善肾衰竭患者营养状况,使得钙磷代谢紊乱得到更好的纠正,值得临床推广应用。

Objective To explore the effect of nutritional intervention on the nutritional status and calcium and phosphorus metabolism of patients with renal failure and undergoing maintenance hemodialysis.Method A total of 100 patients with renal failure who underwent maintenance hemodialysis in our hospital from February 2018 to September 2020 were selected,and randomly divided into observation group and control group by using the random number table method.There was no difference in the age,gender,primary disease,and the time of hemodialysis treatment(P>0.05).And then,the observation group received a 3-month nutritional intervention,and the control group received routine clinical treatment and nursing care.The nutritional status and calcium and phosphorus metabolism of the two groups before and after maintenance hemodialysis,and the nutritional status and calcium and phosphorus metabolism of the two groups after dialysis were compared.Result After maintenance hemodialysis,the level of TP,ALB,PA and HGB of the two groups patients were higher than those before dialysis.After dialysis,the level of TP[(66.28±2.65)vs(63.26±2.84)g/L],ALB[(33.96±1.14)vs(32.22±1.33)g/L],PA[(206.58±13.90)vs(191.38±12.95)mg/L]and HGB[(99.56±3.20)vs(96.60±3.46)g/L]were higher than those in the control group,and the difference was statistically significant(P<0.05).After maintenance hemodialysis,the levels of serum calcium of the two groups patients were higher than those before dialysis,and levels of the serum phosphorus,calcium-phosphorus product and iPTH were lower than those before dialysis.After dialysis,the serum calcium of the nutrition intervention group[(1.48±0.17)vs(1.19±0.18)mmol/L]was significantly higher than that of control group patients,serum phosphorus[(2.77±0.34)vs(3.67±0.25)mmol/L],calcium and phosphorus product[(4.06±0.59)vs(4.38±0.75)mmol2/L2]and iPTH[(260.30±53.72)vs(282.12±57.18)ng/L]levels was significantly lower than that of control group patients,the difference was statistically significant(P<0.05).Conclusion Nutritional intervention can improve the nutritional status,and the disorder of calcium and phosphorus metabolism can be better corrected of patients with renal failure,which is worthy of clinical application.