摘要
目的了解维持性血液透析(MHD)病人的血清游离氨基酸谱及营养状况。方法对49例维持性血液透析病人进行饮食评估;测量身高、体重、三头肌皮褶厚度(TSF)、上臂肌围(MAMC)、体质指数(BMI)、血清总蛋白和白蛋白,检测和分析血清游离氨基酸谱。结果患者平均能量摄入为115.03kJ·kg-1·d～1,蛋白质摄入为1.06g·kg-1·d～2;26.5%的病人BMI<18.5,存在营养不良。以MAMC评估,30.61%的病人存在中重度肌蛋白消耗;以TSF评估,69.38%的病人存在中重度体脂消耗。MHD病人的血清总蛋白和白蛋白水平正常,总氨基酸量、EAA/NEAA、Leu、Ile、。Phe、Val、Lys、Thr、Ser、Ala和Gln水平显著低于正常人(P<0.05,P<0.01),而Asp、Trp、Arg水平则高于正常人(P<0.01)。结论MHD病人存在明显的血清游离氨基酸谱改变,以必需氨基酸水平低下为主,为预防营养不良的进一步发展,应予以合理的营养干预。
Objective To observe the changes of serum free amino acid profile and nutrition status in maintenance hemodialysis (MHD) patients. Methods Forty-nine MHD patients received dietary investigation, and anthropo-metric assessment including height, weight, triceps skinfold (TSF), midarm muscle circumference (MAMC) and body mass index ( BMI) . The serum total protein, albumin and free amino acid profile were also examined. Results The mean energy intake of patients was 115. 03 kJ·kg-1 ·d -l and the mean protein intake was 1. 06 g·kg-1 ·d-1. A total of 26.5% patients had BMI below 18.5. According to TSF and MAMC, the incidence of moderate-to-severe malnutrition was 69. 38% and 30. 61% respectively. The levels of serum total protein and albumin were normal(P < 0.05, P<0. 01). The levels of the total serum amino acids, EAA/NEAA, Leu, Ile, Phe, Val, Lys, Thr, Ser, Ala and Gln in MHD group were lower than the normal. The levels of Asp, Trp and Arg were significantly higher than the normal(P <0. 01). Conclusion There is significant change of serum free amino acid profile in the MHD patients, particularly the essential amino acids. Reasonable nutritional intervention should be done to prevent a further decline in nutritional status.
出处
《上海第二医科大学学报》
CSCD
北大核心
2005年第3期279-281,314,共4页
Acta Universitatis Medicinalis Secondae Shanghai
