摘要： 目的 探讨乳清蛋白治疗腹膜透析患者低蛋白血症的效果。方法 选取2019年8月至2020年8月我院规律随访的腹膜透析且患有低蛋白血症患者100例，随机分为研究组（乳清蛋白饮食）和对照组（高蛋白饮食），每组50例。治疗32周，比较2组治疗前（治疗0周）及治疗8、16、32周时各项指标，包括生物化学指标［血红蛋白（Hb）、血清白蛋白（ALB）、前白蛋白（PA）、甘油三酯（TG）、胆固醇（TC）、血磷（P）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、血肌酐（Scr）、尿素氮（BUN）、估算肾小球滤过率（eGFR）、总尿素清除指数（TKt/V）、总肌酐清除率（TCcr）］和生物学测量指标［握力（HG）、体质量指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂围（AMC）、上臂肌围（MAMC）］。结果 研究组治疗16、32周时ALB、PA、HG较治疗前明显增加（均P < 0.05）。与对照组比较，治疗16、32周时研究组ALB、PA、HG显著升高（均P < 0.05）。而治疗0、8、16、32周时TG、TC、HDL、LDL、eGFR、TKt/V、TCcr 2组比较均无统计学差异（均P > 0.05）。结论 对于蛋白摄入不足或丢失过多而导致低蛋白血症的腹膜透析患者，增加乳清蛋白可以明显改善营养状况，其治疗效果优于单纯高蛋白饮食。

乳清蛋白治疗腹膜透析患者低蛋白血症效果的前瞻性研究

邵耀中, 梁嫦娜, 耿瀛洲, 靳引红, 常露元, 吕晶

西安交通大学第一附属医院肾脏内科, 西安 710061

收稿日期:2023-07-20出版日期:2024-02-28发布日期:2024-01-12
通讯作者:吕晶E-mail:drlvjing@163.com
作者简介:邵耀中(1988-),男,助理研究员,博士.
基金资助:陕西省自然科学基础研究计划（2022JM-598）


关键词: 乳清蛋白, 腹膜透析, 低蛋白血症, 疗效
Abstract: Objective To compare the therapeutic efficacy of whey protein powder in peritoneal dialysis hypoproteinemia patients. Methods From August 2019 to August 2020, 100 patients with peritoneal dialysis hypoproteinemia from the Peritoneal Dialysis Center of the First Affiliated Hospital of Xi'an Jiaotong University were investigated. The patients were separated into 2 groups randomly; the study group were administered whey protein powder and the control group with high protein food. After 32 weeks of treatment, biochemical and biometric indices including hemoglobin (Hb), albumin (ALB), prealbumin (PA), triglyceride (TG), total cholesterol (TC), phosphorus (P), low density lipoprotein (LDL), high density lipoprotein (HDL), serum creatinine (Scr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), total spKt/Vurea (TKt/V), total creatinine clearance rate (TCcr), hand grip strength (HG), triceps skinfold (TSF), arm circumference (AMC), mid-arm muscle circumference (MAMC) were compared between groups. Results Compared with 0 week, at 16 and 32 weeks, ALB, PA, and HG were significantly increased in the study group (P < 0.05). Compared with the control group, ALB, PA, and HG increased significantly at 16 and 32 weeks in the study group (P < 0.05). There were no significant differences in TG, TC, HDL, LDL, eGFR, TKt/V, and TCcr at 0, 8, 16, and 32 weeks between the control and study groups (P > 0.05). Conclusion For patients with peritoneal dialysis hypoproteinemia caused by insufficient protein intake or excessive protein loss, the addition of whey protein during peritoneal dialysis can significantly improve the nutritional status of patients, with greater efficacy than a high protein diet alone.
Key words: whey protein, peritoneal dialysis, hypoproteinemia, therapeutic effect
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