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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 diet on the nutrition of hemodialysis patients with uremia. Methods: Totally 62 patients with uremia hemodialysis treated in our hospital from January 2013 to December 2015 were randomly divided into group A and group B according to the random number table method, with 31 cases in each group. The cross-sectional area of group A In the study, 15 patients with daily protein intake> 1.2 g / kg / day were group A1 and 16 patients with daily protein intake ≤ 1.2 g / kg / day were group A2; group B was prospectively In a cohort study, 16 patients with a daily protein intake> 1.2 g / kg / day were Group B1 and 15 patients with a daily protein intake <1.2 g / kg / day were Group B2, and patients in the comparison group Diet, biochemical indicators and nutritional status. Results: In group A, the DPI, DEI, nPNA and phosphorus in group A1 were significantly higher than those in group B, and the level of CO_2CP was lower in group A than in group A2. There was a significant difference between the two groups in terms of hemoglobin, total protein, prealbumin, total cholesterol , Serum calcium, i PTH and other indicators were not statistically different; B group B1 patients DPI, DEI, nPNA, phosphorus were higher than the B2 group, CO 2 CP level was lower than the B_2 group, the results were statistically significant; the two There was no significant difference in the indexes of hemoglobin, total protein, prealbumin, total cholesterol, serum calcium, iPTH, BMI and AMC in patients with DPI> 1.2g / kg / day and DPI≤1.2g / kg / day Malnutrition rates were the same (both 25.81%), the results were not statistically different. Conclusion: It is suggested that the DPI intake of patients with uremia hemodialysis slightly less than 1.2 g / kg / day, both to meet the daily needs of patients, but also to avoid hyperphosphatemia and acidosis.