饮食蛋白对尿毒症血液透析患者营养影响的分析

Effect of dietary protein on nutritional status in hemodialysis patients with uremia

目的 :分析不同蛋白饮食量对尿毒症血液透析患者营养的影响。方法 :选取2013年1月~2015年12月于我院接受治疗的尿毒症血液透析患者62例,按照随机数表法随机分成A组和B组,每组各31例;A组行横断面研究,每日蛋白摄入量>1.2 g/kg/day的15例患者为A1组,患者每日蛋白摄入量≤1.2g/kg/day的16例患者为A2组;B组行前瞻性队列研究,者每日蛋白摄入量>1.2 g/kg/day的16例患者为B1组,每日蛋白摄入量≤1.2 g/kg/day的15例患者为B2组,分别观察比较患者饮食状况、生化指标以及营养状况。结果 :A组中A1组患者DPI、DEI、nPNA、血磷均高于乙组,CO_2CP水平低于A2组,结果具有统计学差异,两组患者在血红蛋白、总蛋白、前白蛋白、总胆固醇、血钙、i PTH等指标均无统计学差异;B组中B1患者DPI、DEI、nPNA、血磷均高于B2组,CO_2CP水平低于B_2组,结果具有统计学差异;研究过程中两组患者血红蛋白、总蛋白、前白蛋白、总胆固醇、血钙、iPTH、BMI、AMC等指标均无统计学差异;DPI>1.2 g/kg/day组和DPI≤1.2g/kg/day组患者营养不良率相同(均为25.81%),结果均无统计学差异。结论 :建议尿毒症血液透析患者DPI摄入量略低于1.2 g/kg/day,既能满足患者日常需求,又减避高磷血症和酸中毒。

Objective To analyze the effect of different protein diets on nutritional status in uremic hemodialysis patients. Methods 62 cases of hemodialysis patients were selected from January2013 to December2015 in our hospital, randomly di-vided into the group of A and B according to the random number table method of each31 cases; In group A,15 cases of daily protein intake was>1.2 g/kg/day patients for group A1,16 patients daily protein intake is ≤1.2g/kg/day of the patients in group A2; In group B,16 patients daily protein intake was >1.2 g/kg/day of the patients in group B1,15 cases of daily protein intake was ≤1.2 g/kg/day of the patients in group B2, diet condition, biochemical indexes and nutritional status were observed.Result In group A, The group A1of patients with DPI, DEI, nPNA and P were higher than group A2, the CO2CP level was lower than that of group A2, the difference was statistically significant, two groups in hemoglobin, total protein, albumin, total cholesterol, serum calcium, iPTH and other indicators were not statistically significant; In group B, the group B1of patients with DPI, DEI, nPNA and P were higher than group B2, the CO2CP level was lower than that of group B2, the difference was statistically significant; two groups of patients with hemoglobin, total protein, albumin, total cholesterol, serum calcium, iPTH, BMI, AMC, there was no significant difference in the course of the study; Malnutrition rate of DPI>1.2 g/kg/day and DPI≤1.2g/kg/day were the same (all 25.81%), and the results were not statistically significant.Conclusion It is suggested that the DPI intake of uremic hemodialysis patients is slightly less than1.2 g/kg/day, which can not only meet the daily needs of patients, but also reduce the level of high phosphorus and acid poisoning.