个性化膳食管理对维持性血液透析患者血磷的影响

The effect of individualized diet management on blood phosphorus in maintenance hemodialysis patients

目的探讨个性化膳食管理对维持性血液透析患者血磷(P)的影响。方法 60例维持性血液透析患者,随机分为对照组和研究组,每组30例。对照组行常规干预,研究组在对照组基础上联合个性化膳食管理。对比两组患者干预6个月后人体测量指标[上臂三头肌处皮下脂肪厚度(TSF)、体质量指数(BMI)、上臂肌围(MAMC)]以及实验室检查指标[P、钙(Ca)、血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)]。结果干预6个月后,研究组患者TSF、BMI以及MAMC分别为(10.4±1.5)mm、(22.5±2.7)kg/m^(2)、(16.9±0.8)mm,均优于对照组的(8.3±1.3)mm、(18.5±2.3)kg/m^(2)、(15.4±0.6)mm,差异具有统计学意义(P<0.05)。干预6个月后,研究组患者P水平低于对照组, Ca、Hb、PA、ALB水平高于对照组,差异具有统计学意义(P<0.05)。结论个性化膳食管理可改善维持性血液透析患者的营养状况,增强患者体质,降低P水平,特别适用于合并高磷血症的维持性血液透析患者。

Objective To discuss the effect of individualized diet management on blood phosphorus(P)in maintenance hemodialysis patients.Methods A total of 60 patients undergoing maintenance hemodialysis were randomly divided into control group and research group,with 30 cases in each group.The control group received conventional intervention,and the research group received individualized diet management based on the control group.The anthropometric indicators[triceps skin-fold thickness(TSF),body mass index(BMI),midarm muscle circumference(MAMC)]and laboratory inspection indicators[P,calcium(Ca),hemoglobin(Hb),prealbumin(PA),albumin(ALB)]after 6 months of intervention were compared between the two groups.Results After 6 months of intervention,the TSF,BMI and MAMC of the research group were(10.4±1.5)mm,(22.5±2.7)kg/m^(2) and(16.9±0.8)mm,which were all better than(8.3±1.3)mm,(18.5±2.3)kg/m^(2) and(15.4±0.6)mm of the control group,and the difference was statistically significant(P<0.05).After 6 months of intervention,the P level of the research group was lower than that of the control group,and the levels of Ca,Hb,PA and ALB were higher than those of the control group.All the difference was statistically significant(P<0.05).Conclusion Individualized diet management can improve the nutrition status of maintenance hemodialysis patients,enhance their physical fitness and reduce P levels.It is especially suitable for maintenance hemodialysis patients with hyperphosphatemia.