医学营养治疗对糖尿病肾病维持性血液透析患者肾功能及营养状况的影响

Effects of Medical Nutritional Therapy on Renal Function and NutritionalStatus of Maintenance Hemodialysis Patients with Diabetic Kidney Disease

目的分析医学营养治疗对糖尿病肾病维持性血液透析患者肾功能及营养状况的影响。方法选取2021年1月—2022年1月在中国人民解放军陆军第七十三集团军医院就诊的糖尿病肾病维持性血液透析患者110例作为研究对象,根据患者治疗意愿进行分组,在常规治疗基础上实施膳食指导的患者(n=54)设置为对照组,在常规治疗基础上采用医学营养治疗的患者(n=56)设置为观察组。连续治疗6个月后对比两组患者肾功能及营养状况。结果出院3、6个月时观察组血清β_(2)微球蛋白、血肌酐水平均低于对照组,差异有统计学意义(P<0.05),进一步重复测量分析得出,两组血清β_(2)微球蛋白、血肌酐水平随着时间变化的变化趋势不同(P<0.05)。出院3、6个月时观察组血清白蛋白及前白蛋白水平均高于对照组,差异有统计学意义(P<0.05),重复测量分析两组血红蛋白水平随着时时间变化的变化趋势相同(P>0.05),两组血清血清白蛋白及前白蛋白水平随着时间变化的变化趋势不同(P<0.05)。结论医学营养治疗对糖尿病肾病维持性血液透析患者肾功能及营养状况具有改善作用,效果确切。

Objective To analyze the effects of medical nutrition therapy on renal function and nutritional status of maintenance hemodialysis patients with diabetic kidney disease.Methods A total of 110 diabetic kidney disease maintenance hemodialysis patients treated in the 73rd Group Military Hospital of the Chinese People's Liberation Army from January 2021 to January 2022 were selected as the study objects.The patients were divided into groups ac-cording to their treatment intention,and those who received dietary guidance on the basis of conventional treatment(n=54)were set as the control group.Patients treated with medical nutrition in addition to conventional treatment(n=56)were assigned to the observation group.The renal function and nutritional status of the two groups were compared after 6 months of continuous treatment.Results At 3 and 6 months after discharge,the levels of serumβ_(2)microglobulin and serum creatinine in the observation group were lower than those in the control group,and the differences were sta-tistically significant(P<0.05).Further repeated measurement analysis showed that the levels of serumβ_(2)microglobu-lin and serum creatinine in the two groups had different trends over time(P<0.05).Serum albumin and prealbumin lev-els in the observation group were higher than those in the control group at 3 and 6 months after discharge,and the dif-ference was statistically significant(P<0.05).Repeated measurement analysis showed that the hemoglobin level of the two groups had the same change trend with time change(P>0.05).The levels of serum albumin and prealbumin in two groups were different with time(P<0.05).Conclusion Medical nutritional therapy has an improving effect on renal function and nutritional status of patients with diabetic renal disease on maintenance hemodialysis,the effect is exact.