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口服能量补充改善蛋白质能量消耗的血液透析患者的营养状况:一项试点研究。

Oral energy supplementation improves nutritional status in hemodialysis patients with protein-energy wasting: A pilot study.

作者信息

Qin Aiya, Tan Jiaxing, Hu Wen, Liu Yuan, Chen Lin, Tang Yi, Qin Wei

机构信息

Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Pharmacol. 2022 Oct 21;13:839803. doi: 10.3389/fphar.2022.839803. eCollection 2022.

Abstract

Protein-energy wasting (PEW) is highly prevalent in hemodialysis (HD) patients, which is associated with poor quality of life, complications, and an increased risk of mortality. A prospective study in HD patients with 2 months of oral energy supplements (OESs) was performed. A total of 37 HD patients with PEW were finally enrolled in this prospective study and were randomized into the OES group ( = 19), which received oral energy supplementation (300 kcal) and dietary recommendations, while patients in the non-OES group ( = 18) received only dietary recommendations. The study duration was 2 months. The nutritional status of the patients was evaluated by laboratory indexes, body composition parameters, and the modified quantitative subjective global assessment (MQSGA) and malnutrition-inflammation score (MIS). Quality of life was evaluated by the Short Form Health Survey Questionnaire (SF-36). After 2 months of therapy, a significant increase in serum albumin [39.6 (37.6-45.8) vs. 43.4 (39.1-46.7) g/L; 0.018], hemoglobin (101.0 ± 13.6 g/L vs. 111.8 ± 11.7 g/L; 0.042), and dietary energy intake (29.17 ± 3.22 kcal/kg/day vs. 33.60 ± 2.72 kcal/kg/day, < 0.001) was observed in the comparisons of baseline in the OES group. Moreover, the OES group demonstrated significant amelioration in MQSGA [9 (8-13) vs. 8 (7-12), < 0.001] and MIS [5 (3-10) vs. 3 (2-8), < 0.001], physical functioning ( < 0.001), and mental health ( 0.046) subsections of SF-36 compared with the baseline. No electrolyte disorders or dyslipidemia were observed in the OES group. OES in HD patients with PEW can significantly ameliorate energy supply, nutritional status, anemia, and quality of life.

摘要

蛋白质能量消耗(PEW)在血液透析(HD)患者中非常普遍,这与生活质量差、并发症以及死亡风险增加有关。对HD患者进行了一项为期2个月的口服能量补充剂(OES)前瞻性研究。共有37例患有PEW的HD患者最终纳入这项前瞻性研究,并被随机分为OES组(n = 19),该组接受口服能量补充(300千卡)和饮食建议,而非OES组(n = 18)的患者仅接受饮食建议。研究持续时间为2个月。通过实验室指标、身体成分参数、改良的定量主观全面评估(MQSGA)和营养不良炎症评分(MIS)评估患者的营养状况。通过简短健康调查问卷(SF - 36)评估生活质量。治疗2个月后,与基线相比,OES组血清白蛋白显著增加[39.6(37.6 - 45.8)对43.4(39.1 - 46.7)g/L;P = 0.018]、血红蛋白(101.0 ± 13.6 g/L对111.8 ± 11.7 g/L;P = 0.042)以及饮食能量摄入(29.17 ± 3.22千卡/千克/天对33.60 ± 2.72千卡/千克/天,P < 0.001)。此外,与基线相比,OES组在MQSGA[9(8 - 13)对8(7 - 12),P < 0.001]和MIS[5(3 - 10)对3(2 - 8),P < 0.001]、SF - 36的身体功能(P < 0.001)和心理健康(P = 0.046)子部分方面有显著改善。OES组未观察到电解质紊乱或血脂异常。对于患有PEW的HD患者,OES可显著改善能量供应、营养状况、贫血和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b12/9633655/beecdf7efcf7/fphar-13-839803-g001.jpg

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