目的：探讨改良低蛋白质饮食联合复方α酮酸改善维持性血液透析（MHD）患者钙磷代谢和营养状况的临床价值。方法选择MHD患者40例，随机分为对照组18例，实验组22例。对照组开放蛋白饮食并给予碳酸钙(600 mg bid)，实验组给予改良低蛋白饮食加复方α酮酸12片/d。比较两组患者的血磷、血钙、全段甲状旁腺素(iPTH)、体质量指数(BMI)、血红蛋白(Hb)、血浆白蛋白(Alb)和上臂肌围(AMC)的变化。结果与治疗前比较，治疗后，实验组血钙、钙磷乘积呈升高趋势(P<0.05)，血磷呈降低趋势(P<0.01)，iPTH无变化(P>0.05)。对照组血磷、血钙、钙磷乘积、iPTH均呈升高趋势(P<0.05或P<0.01)。与治疗前比较，治疗后两组BMI、Hb、Alb、AMC均呈升高趋势(P<0.05)，两组间治疗前、后各营养指标比较差异均无统计学意义(P>0.05)。结论复方α酮酸联合改良低蛋白质饮食可有效改善患者钙磷代谢紊乱，同时并不会导致营养不良的发生，具有一定的临床应用价值。%Objective To investigate the Clinical value of using low protein diet supplemented withα-keto acid to improve calcium-phosphorus metabolism in maintenance hemodialysis patients. Methods A total of 40 hemo-dialysis patients were investigated and followed-up for half a year.They were randomly divided into two groups. Con-trol group were 18 cases, experimental group were 22 cases. Control group were given routine protein diet and calci-um carbonate (600 mg bid), experimental group were given low protein diet supplemented withα-keto acid (12 pieces per day). Compared the serum level of calcium, phosphate, intraoperative parathormone (iPTH), serum albumin (Alb), hemoglobin (Hb), body mass index (BMI),and arm muscle circumference(AMC) between two groups. Results In experimental group, serum calcium and calcium and phosphate product were increased (P<0.05), phosphate level was decreased (P<0.01), iPTH remained stable in a low level (P>0.05). In control group, serum calcium, phosphate, calci-um and phosphate product and iPTH levels were increased significantly (P<0.05 or P<0.01). Alb, Hb, BMI and AMC were increased significantly in both two groups (P<0.05), but these values had no signifieant differences before and af-ter the treatment(P>0.05). Conclusion Low protein diet supplemented withα-keto acid can improve calcium-phos-phorus metabolism and will not lead to malnutrition. It Has a certain application value in clinical.
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