标题：复方α-酮酸对维持性血液透析患者营养状态及微炎症的影响

      作者：陈凯均，王欢，刁秀平    龙川县人民医院内一科，广东 龙川 517300

      卷次： 2019年30卷14期

      【摘要】 目的 探讨复方α-酮酸对维持性血液透析(MHD)患者营养状态及微炎症的影响。方法 选择龙川县人民医院2017年1月至2018年8月期间治疗的70例维持性血液透析患者为研究对象，根据随机数表法将患者分为观察组(n=35)和对照组(n=35)，对照组予常规MHD治疗，保证热量摄入[30~35 kcal/(kg·d)]，观察组患者在对照组基础上联合应用复方α-酮酸片治疗，疗程为3个月。比较两组患者治疗前后的血清白蛋白(Alb)、前白蛋白(PA)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)水平的变化。结果 治疗前两组患者的血清Alb、PAB及 hs-CRP、IL-6及TNF-α水平比较差异均无统计学意义(P>0.05)；治疗后，观察组患者的血清Alb、PA水平分别为(37.94±2.82) g/L、(198.46±43.83) mg/L，明显高于治疗前，且明显高于对照组治疗后的(34.15±2.67) g/L、(176.28±32.54) mg/L，差异均有统计学意义(P<0.05)；治疗后观察组患者的血清hs-CRP、IL-6及TNF-α水平分别为(7.85±2.54) mg/L、(15.36±4.23) pg/mL、(26.24±7.43) pg/mL，明显低于治疗前，且明显低于对照组治疗后的(12.34±4.04) mg/L、(22.25±6.18) pg/mL、(40.72±12.65) pg/mL，差异均有统计学意义(P<0.05)；对照组患者治疗后，血清Alb、PAB及hs-CRP、IL-6及TNF-α水平分别与治疗前比较差异均无统计学意义(P>0.05)。结论 在常规治疗的基础上加用复方α-酮酸片治疗MHD患者可以有效改善患者的微炎症状态及营养状况。
      【关键词】 维持性血液透析；营养不良；微炎症状态；复方α-酮酸；并发症
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350（2019）14—1791—03

Effect of compound α-keto acid therapy on nutritional status and microinflammation in patients undergoingmaintenance hemodialysis.
CHEN Kai-jun, WANG Huan, DIAO Xiu-ping. Department of Internal Medicine, the People'sHospital of Longchuan County, Longchuan 517300, Guangdong, CHINA
【Abstract】 Objective To investigate the effects of compound α-keto acid on nutritional status and microin-flammation in patients undergoing maintenance hemodialysis (MHD). Methods Seventy patients undergoing MHDwho were treated in the hemodialysis room of the People's Hospital of Longchuan County from January 2017 to August2018 were selected as the research objects. According to random number table method, the patients were divided into thetreatment group (n=35) and control group (n=35). Patients in control group was given routine MHD treatment with calo-rie intake 30-35 kcal/(kg·d). Patients in the treatment group were treated with compound α-keto acid tablets on the basisof the control group. The treatment lasted 3 months. The levels of serum albumin (Alb), prealbumin (PA), hypersensitiveC-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were compared between thetwo groups before and after treatment. Results Before treatment, there was no significant difference in serum Alb,PAB, hs-CRP, IL-6 and TNF-α between the two groups (P>0.05). After treatment, the levels of serum Alb and PA in thetreatment group were (37.94 ± 2.82) g/L and (198.46 ± 43.83) mg/L, respectively, which were significantly higher thanthose before treatment, and also significantly higher than corresponding (34.15±2.67) g/L and (176.28±32.54) mg/L inthe control group (all P<0.05). The serum hs-CRP, IL-6 and TNF-α in the treatment group were (7.85 ± 2.54) mg/L,(15.36±4.23) pg/mL and (26.24±7.43) pg/mL, respectively, which were significantly lower than those before treatment, andalso significantly lower than corresponding (12.34±4.04) mg/L, (22.25±6.18) pg/mL, (40.72±12.65) pg/mL of the controlgroup (all P<0.05); there was no significant difference in serum levels of Alb, PAB, hs-CRP, IL-6 and TNF-α in the con-trol group before and after treatment (P>0.05). Conclusion For patients with MHD, adding compound α-ketonic acidon the basis of routine treatment can effectively improve the microinflammation and nutritional status of patients.
      【Key words】 Maintenance hemodialysis (MHD); Malnutrition; Microinflammation; Compound α-keto acid;Complications