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《复方α酮酸配伍低蛋白饮食对长期腹膜透析患者微炎症的影响及其与营养状态关系的随机对照研究》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、复方α酮酸配伍低蛋白饮食对长期腹膜透析患者微炎症的影响及其与营养状态关系的随机对照研究作者:谌卫,郭志勇,吴灏,孙莉静,蔡莉莉,徐海燕【摘要】观察复方α酮酸配伍低蛋白饮食对长期持续性不卧床腹膜透析(continuousambulatoryperitonealdialysis,CAPD)患者血浆炎症因子水平变化的影响及其与营养状态的关系。【关键词】低蛋白质膳食;酮酸类;腹膜透析;炎症;营养不良 Objective:Toinvestigatetheeffectsofthecombinationo
2、fαketoacidandlowproteindietonthelevelsofserumcytokinesinpatientsperformingcontinuousambulatoryperitonealdialysis(CAPD)andtoexploretherelationshipbetweeninflammationandmalnutritioninCAPDpatients. Methods:EightynineCAPDpatientswererandomizedintothre
3、egroups,and78casescompletedaoneyearfollowupandwithcompletedata.Therewere31casesinlowproteindietplusαketoacidgroup,26casesinlowproteindietgroupand21casesinroutineproteindietgroup.Thelevels13ofserumalbumin(Alb),prealbumin(PA),retinolbindingprotei
4、n(RBP),transferrin(TRF),cholesterol(TC),triglycerides(TG),leptin,andtricepsskinfoldthickness(TSF),midarmmusclecircumference(MAMC),bodymassindex(BMI)weremeasured.Thechangesofseruminterleukin1α(IL1α),interleukin6(IL6),tumornecrosisfactorα(TNFα)an
5、dCreactiveprotein(CRP)werealsodetected. Results:Comparedwithlowproteindietgroup,serumlevelsofPA,RBPandTRFweresignificantlyincreasedbothinlowproteindietplusαketoacidandroutineproteindietgroups(P<0.01),however,therewasnosignificantdifferenceint
6、helevelsofPA,RBPandTRFbetweenlowproteindietplusαketoacidgroupandroutineproteindietgroup.TherewasanincreasedtendencyinthecontentofAlb,TC,TG,BMI,TSFandMAMC,buttherewerenosignificantdifferences.TheplasmalevelsofIL1α,IL6andTNFαinlowproteindietplusα
7、ketoacidgroupweredecreasedascomparedwiththeroutineproteindietgroup,buttherewerenosignificantdifferences.TheplasmalevelofCRPinlowproteindietplusαketoacidgroupwaslowerthanthatintheroutineproteindietgroup(P<0.01).13 Conclusion:Thecombinationofα
8、ketoacidandlowproteindietcanamelioratemalnutritionandmicroinflammationinCAPDpatients. Keywords:lowproteindiet;ketoacids;peritonealdialysis;inflammation;malnutrition 近年来,营养状态作为影响透析患者生存质量的一个重要指标逐渐受到重视。一方面,透析患者营养不良的发生发展主要与体内微炎症状态密切相关[1],另一方