左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究

发布时间：2018-07-08 17:42

本文选题：蛋白能量消耗 + 维持性血液透析　；参考：《第三军医大学学报》2016年18期

【摘要】：目的研究左卡尼汀治疗维持性血液透析(maintenance hemodialysis,MHD)患者蛋白质能量消耗(protein energy wasting,PEW)的效果。方法回顾性选取2003年1月至2015年6月在贵州省人民医院进行维持性血液透析并诊断为PEW患者99例。按患者是否使用左卡尼汀分为治疗组和对照组,其中治疗组75例,对照组24例。采用独立样本t检验和χ2检验比较两组患者生化指标(包括白蛋白、前白蛋白、血红蛋白、淋巴细胞总数等)、主观全面营养评估(subjective global assessment,SGA)评分、体格测量(包括体质量、体质量指数、上臂肌围、肱三头肌皮褶厚度、小腿围)和人体成分测量(瘦体质量、脂肪质量和相位角)结果。结果左卡尼汀治疗组治疗后血红蛋白、前白蛋白、白蛋白较治疗前升高,差异有统计学意义(P0.05),也高于对照组(P0.05)。用SGA评分判断,治疗组营养良好患者比例高于对照组(22.7%vs 4.2%),而轻中度营养不良和重度营养不良患者比例均显著低于对照组(76.0%vs 83.3%,1.3%vs 12.5%),差异有统计学意义(P0.05)。体格测量显示,治疗组男性和女性的体质量指数、肱三头肌皮褶厚度、小腿围均分别高于对照组,差异有统计学意义(P0.05)。生物电阻抗法检测体质成分结果显示,治疗组瘦体质量明显高于对照组(P0.05),但脂肪质量和相位角较对照组差异无统计学意义(P0.05)。结论 MHD患者经左卡尼汀治疗可有效改善营养状况,预防患者体质量丢失,尤其是瘦体质量的丢失,从而改善患者的PEW,有望将来用于预防MHD患者的肌肉减少症,提高生活质量。
[Abstract]:Objective to study the effect of levacarnitine in the treatment of maintenance hemodialysis (maintenance hemodialysis) patients with (protein energy expenditure (PEW). Methods from January 2003 to June 2015, 99 patients with PEW were treated with maintenance hemodialysis in Guizhou Provincial people's Hospital. Patients were divided into treatment group (75 cases) and control group (24 cases). Independent sample t test and 蠂 2 test were used to compare the biochemical indexes (including albumin, prealbumin, hemoglobin, total lymphocyte count, etc.), subjective comprehensive nutrition assessment (subjective global) score, physical measurement (including body mass). Body mass index, upper arm muscle circumference, triceps skinfold thickness, calf circumference) and body composition measurements (lean body mass, fat mass and phase angle). Results the levels of hemoglobin, prealbumin and albumin in levocarnitine group were significantly higher than those before treatment (P0.05) and higher than that in control group (P0.05). The proportion of patients with good nutrition in the treatment group was higher than that in the control group (22.7%vs 4.2%), while the proportion of patients with mild to moderate malnutrition and severe malnutrition in the treatment group was significantly lower than that in the control group (76.0%vs 83.3% vs 12.5%). The difference was statistically significant (P0.05). Physical measurement showed that the body mass index, triceps skinfold thickness and leg circumference of male and female in the treatment group were higher than those in the control group, the difference was statistically significant (P0.05). The results of bioelectrical impedance test showed that the weight of thin body in the treatment group was significantly higher than that in the control group (P0.05), but the fat mass and phase angle had no statistical significance compared with the control group (P0.05). Conclusion Levocarnitine therapy can effectively improve the nutritional status and prevent the loss of body mass, especially the loss of lean body mass in patients with MHD, so as to improve the PEWs of patients with MHD, which is expected to be used to prevent myopenia and improve the quality of life in MHD patients in the future.
【作者单位】：第三军医大学大坪医院野战外科研究所临床营养科;贵州省人民医院肾内科;
【基金】：重庆市医学重点学科建设项目(2012)~~
【分类号】：R459.5

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