复方α酮酸配伍低蛋白饮食对长期腹膜透析患者微炎症影响及其.docVIP

复方α酮酸配伍低蛋白饮食对长期腹膜透析患者微炎症影响及其 　 作者：谌卫, 郭志勇, 吴灏, 孙莉静, 蔡莉莉, 徐海燕 【摘要】 观察复方α酮酸配伍低蛋白饮食对长期持续性不卧床腹膜透析（continuous ambulatory peritoneal dialysis, CAPD）患者血浆炎症因子水平变化的影响及其与营养状态的关系。 【关键词】 低蛋白质膳食; 酮酸类; 腹膜透析; 炎症; 营养不良 　　Objective: To investigate the effects of the combination of αketo acid and lowprotein diet on the levels of serum cytokines in patients performing continuous ambulatory peritoneal dialysis (CAPD) and to explore the relationship between inflammation and malnutrition in CAPD patients. 　　Methods: Eightynine CAPD patients were randomized into three groups, and 78 cases completed a oneyear followup and with complete data. There were 31 cases in lowprotein diet plus αketo acid group, 26 cases in lowprotein diet group and 21 cases in routineprotein diet group. The levels of serum albumin (Alb), prealbumin (PA), retinolbinding protein (RBP), transferrin (TRF), cholesterol (TC), triglycerides (TG), leptin, and triceps skinfold thickness (TSF), midarm muscle circumference (MAMC), body mass index (BMI) were measured. The changes of serum interleukin1α (IL1α), interleukin6 (IL6), tumor necrosis factorα (TNFα) and Creactive protein (CRP) were also detected. 　　Results: Compared with lowprotein diet group, serum levels of PA, RBP and TRF were significantly increased both in lowprotein diet plus αketo acid and routineprotein diet groups (Plt;0.01), however, there was no significant difference in the levels of PA, RBP and TRF between lowprotein diet plus αketo acid group and routineprotein diet group. There was an increased tendency in the content of Alb, TC, TG, BMI, TSF and MAMC, but there were no significant differences. The plasma levels of IL1α, IL6 and TNFα in lowprotein diet plus αketo acid group were decreased as compared with the routineprotein diet group, but there were no significant differences. The plasma level of CRP in lowprotein diet plus αketo acid group was lower than that in the routineprotein diet group (Plt;0.01). 　　Conclusi