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目的观察尿毒营养膏对维持性血液透析患者血清瘦素及营养状态的影响,进一步阐明瘦素与营养状态的关系。方法将60例患者随机分为治疗组和安慰剂组,每组30例。两组均予低盐、低脂、优质低蛋白、低磷、高热量饮食,积极治疗原发病及并发症,控制炎症及维持水电解质平衡,维持规律血液透析;治疗组同时予尿毒营养膏治疗,安慰剂组予尿毒营养膏安慰剂治疗。两组疗程均为6个月,观察主要症状体征、营养状况(SGA)评分以及血红蛋白、血清白蛋白、胆固醇等指标的变化情况。同时以30例健康人为健康对照组,观察维持性血液透析营养不良患者血清瘦素(IP)水平,以及治疗组和安慰剂组干预措施对其的影响。结果①治疗组治疗后主要症状体征及SGA积分明显减少(P<0.05),安慰剂组均无明显变化(P>0.05);组间治疗后比较,主要症状体征及SGA积分差异均有统计学意义(P<0.05)。②治疗组、安慰剂组血清LP水平明显高于健康对照组(P<0.05);治疗组治疗后血清LP水平显著下降(P<0.05),安慰剂组无明显变化(P>0.05);治疗组、安慰剂组试验后比较,血清LP水平差异有统计学意义(P<0.05)。③治疗后治疗组Alb、CHOL明显降低(P<0.05),安慰剂组各指标均无变化(P>0.05);组间治疗后比较,Alb、CHOL差异有统计学意义(P<0.05)。结论尿毒营养膏能够改善维持性血液透析患者的营养状态,降低瘦素水平。
Objective To observe the effect of nourishing nutrient paste on serum leptin and nutritional status in maintenance hemodialysis patients and further elucidate the relationship between leptin and nutritional status. Methods Sixty patients were randomly divided into treatment group and placebo group, 30 cases in each group. Both groups were given low-salt, low-fat, high-quality low-protein, low-phosphorus, high-calorie diet, active treatment of primary disease and complications, control of inflammation and maintain water and electrolyte balance, to maintain regular hemodialysis; Treatment, placebo group to uremic nutrition cream placebo treatment. The two courses of treatment were 6 months, observed the main symptoms and signs, nutritional status (SGA) score and hemoglobin, serum albumin, cholesterol and other indicators of changes. At the same time, 30 healthy individuals were selected as healthy control group to observe the serum leptin (IP) level in maintenance hemodialysis patients with malnutrition, and the effects of interventions in treatment group and placebo group. Results ① After treatment, the main symptoms, signs and SGA scores of the treatment group were significantly decreased (P <0.05), and no significant changes were found in the placebo group (P> 0.05). After treatment, the main symptoms and signs and SGA scores were statistically different Significance (P <0.05). (2) Serum LP levels in treatment group and placebo group were significantly higher than those in healthy control group (P <0.05); serum LP level was significantly decreased (P <0.05) in treatment group and no significant difference in placebo group (P> 0.05) Compared with the placebo group, the difference of serum LP level was statistically significant (P <0.05). ③ After treatment, Alb and CHOL in the treatment group were significantly decreased (P <0.05), while those in the placebo group were unchanged (P> 0.05). Alb and CHOL in the treatment group were significantly different (P <0.05). Conclusion Uremic nutritional supplements can improve nutritional status of maintenance hemodialysis patients and reduce leptin levels.