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目的:研究五步协同营养支持方案对终末期糖尿病肾病(end-stage diabetic nephropathy, ESDN)透析患者营养指标、胰岛素抵抗及残余肾功能的影响。方法:选取2018年1月至2019年8月于我院就诊的ESDN透析患者125例，按照数字表法随机分为对照组和研究组。对照组给予常规营养支持，研究组给予五步协同营养支持方案。3个月后观察两组患者营养状态、胰岛素抵抗、残余肾功能情况。结果:干预后研究组血清总蛋白、血红蛋白、转铁蛋白、白蛋白显著高于对照组(均n P<0.05)，空腹血糖水平、空腹胰岛素水平、胰岛素抵抗指数、血清尿素氮、血肌酐显著低于对照组(均n P<0.05)。n 结论:五步协同营养支持方案能够显著提高ESDN透析患者的营养指标，改善胰岛素抵抗，减轻肾脏炎症反应，改善残余肾功能。“,”Objective:To study the effect of five-step collaborative nutritional support program on nutritional indexes, insulin resistance and residual renal function of end-stage diabetic nephropathy (ESDN) dialysis patients.Methods:From January 2018 to August 2019, 125 ESDN dialysis patients who were treated in our hospital were divided into the control group and the research group according to the random number table method. The control group was given routine nutritional support, and the research group was given five-step collaborative nutritional support program. The nutritional status, insulin resistance, and residual renal function of the two groups were tested at 3 months.Results:Total serum protein, hemoglobin, transferrin, and albumin in the research group were significantly higher than those in the control group (all n P<0.05). Fasting blood glucose, fasting insulin, insulin resistance index, serum urea nitrogen, and blood creatinine were significantly lower than those in the control group (alln P<0.05).n Conclusion:The five-step collaborative nutritional support program could significantly improve the nutritional status, insulin resistance, and residual renal function of ESDN dialysis patients.