营养因素对糖尿病肾病行腹膜透析患者的影响分析(1)
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[摘要] 目的 探讨营养因素对糖尿病肾病行腹膜透析患者的影响。 方法 选取我院肾内科2009年1月～2012年1月收治入院的糖尿病肾病行腹膜透析患者82例进行饮食干预，随机分为干预组与对照组，各41例，对照组患者进行常规护理，干预组患者在对照组的基础上进行全面系统的饮食干预，6个月后比较干预组与对照组患者营养状况和血糖控制情况，并采用Logistic回归分析营养因素对糖尿病肾病行腹膜透析患者的影响。结果 干预组患者的握力、皮下脂肪厚度、上臂中点围和上臂肌围与对照组相比数值明显升高，差异有统计学意义(P < 0.05)。干预组血糖控制良好，FPG、2h PG和HbA1c均明显低于对照组，差异有统计学意义(P < 0.05)。Logistic回归分析显示碳水化合物、脂肪及酒精为糖尿病肾病行腹膜透析患者的危险因素。 结论 对糖尿病肾病行腹膜透析患者进行饮食干预后能改善患者的营养状况，降低患者的血糖水平。碳水化合物、脂肪及酒精为糖尿病肾病行腹膜透析患者的危险因素，应进行严格控制。
[关键词] 糖尿病肾病；腹膜透析；营养因素
[中图分类号] R473.5 [文献标识码] B [文章编号] 1673—9701(2012)27—0040—02
The effect analysis of trophic factors on the patients with diabetic nephropathy undergoing peritoneal dialysis
CAO Li1 SHEN Jian2
1.Nephrology Department，the First People’s Hospital of Hangzhou City，Hangzhou 310006，China；2.Department of Nursing，Zhejiang Medical High Training School，Hangzhou 310053，China
[Abstract] Objective To study the effect of trophic factors on the patients with diabetic nephropathy undergoing peritoneal dialysis. Methods Diet intervention was carried out in 41 cases of the patients with diabetic nephropathy undergoing peritoneal dialysis in the nephrology department of our hospital from January 2009 to January 2012.Compared the nutritional status and the control situation of blood sugar between the intervention group and the control group after six months of intervention；and the meantime used the Logistic regression analysis to analyze the effect of the nutrition factors on the patients with diabetic nephropathy undergoing peritoneal dialysis. Results There was a significant difference in HGS，triceps skin fold thickness(TSF)， mid—arm circumference(MAC)，mid—arm muscle circumference(MAMC)，FPG，2h PG and HbA1c compared with those before intervention(P < 0.05). The Logistic regression analysis showed that the carbohydrate， fat and alcohol were the risk factors of the patients with diabetic nephropathyand undergoing peritoneal dialysis. Conclusion Diet intervention could improve the nutritional status for the patients with diabetic nephropathy undergoing peritoneal dialysis and reduce the level of the blood glucose. Carbohydrate，fat and alcohol were the risk factors for the patients with diabetic nephropathy undergoing peritoneal dialysis， which should be strictly controlled.
[Key words] Diabetic nephropathy；Peritoneal dialysis；Trophic factor
中华医学会糖尿病学分会于2007～2008年对我国人群进行了一项糖尿病筛查，结果推测我国糖尿病患者已达9300万人，成为严重影响我国人民身心健康的主要公共卫生性问题[1]。目前，我国糖尿病患者摄人食物种类少，食物摄入量也少，应该予以调整和改善，造成这种结果的原因主要是患者缺乏对糖尿病饮食的正确认识和专门的营养指导[2]。同时，糖尿病肾病行腹膜透析患者营养不良的发生率明显高于非糖尿病者[3]。因此，研究营养因素对糖尿病肾病腹膜透析患者的影响具有十分重要的意义。本实验对我院肾内科41例糖尿病肾病行腹膜透析患者进行营养因素干预处理6个月，临床效果明显，现报道如下。
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