【摘要】：目的:1)了解新疆地區(qū)T2DM患者的飲食現(xiàn)狀及氧化應(yīng)激水平;2)評價(jià)個(gè)性化飲食干預(yù)對T2DM患者營養(yǎng)風(fēng)險(xiǎn)發(fā)生率、營養(yǎng)素?cái)z入量、氧化應(yīng)激指標(biāo)、糖代謝指標(biāo)、脂代謝指標(biāo)以及人體測量學(xué)指標(biāo)的影響。方法:選取新疆醫(yī)科大學(xué)第一附屬醫(yī)院內(nèi)分泌科2016年1月到2016年12月住院治療的T2DM患者160例,按照隨機(jī)數(shù)字表法將患者分為對照組與實(shí)驗(yàn)組,每組各80例。所有參加本研究的T2DM患者除飲食有分組要求以外,其余原有的DM治療方案和生活方式嚴(yán)格維持原狀,時(shí)間全程3個(gè)月。在此基礎(chǔ)上對照組患者給予醫(yī)院常規(guī)飲食健康教育和傳統(tǒng)的食物交換份法進(jìn)行飲食干預(yù);實(shí)驗(yàn)組患者給予個(gè)性化飲食干預(yù)。通過檢測兩組受試者血清中氧化應(yīng)激(測定血清丙二醛含量,以評價(jià)機(jī)體氧化應(yīng)激;測定血清超氧化物歧化酶、維生素C、維生素E含量,評價(jià)機(jī)體的抗氧化防御)、糖代謝、脂代謝指標(biāo)含量,以及人體測量學(xué)指標(biāo)的變化,比較干預(yù)前后兩組患者各指標(biāo)的改善及相關(guān)性,分析氧化應(yīng)激水平的差異性。結(jié)果:1)基線情況調(diào)查結(jié)果:兩組患者在人口學(xué)資料、疾病狀態(tài)、營養(yǎng)風(fēng)險(xiǎn)篩查評分等方面差異無統(tǒng)計(jì)學(xué)意義(P0.05);2)干預(yù)前后組間比較:干預(yù)后實(shí)驗(yàn)組患者營養(yǎng)素?cái)z入量(碳水化合物、鈣、鋅、硒、VC、VE)、氧化應(yīng)激指標(biāo)(超氧化物歧化酶、維生素C、維生素E)及高密度脂蛋白膽固醇均有升高;營養(yǎng)風(fēng)險(xiǎn)發(fā)生率、能量、脂肪、鈉、蛋白質(zhì)、丙二醛、糖代謝指標(biāo)、甘油三酯、總膽固醇、低密度脂蛋白膽固醇及人體測量學(xué)均降低;與對照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);3)兩組患者自身前后組內(nèi)比較:實(shí)驗(yàn)組患者干預(yù)后與干預(yù)前相比較,營養(yǎng)素?cái)z入量(碳水化合物、鈣、鋅、硒、VC、VE)、氧化應(yīng)激指標(biāo)(超氧化物歧化酶、維生素C、維生素E)、高密度脂蛋白膽固醇指標(biāo)均明顯升高;能量、脂肪、鈉、蛋白質(zhì)、丙二醛、糖代謝指標(biāo)、甘油三酯、總膽固醇、低密度脂蛋白膽固醇及人體測量學(xué)等指標(biāo)均降低,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。對照組糖代謝指標(biāo)與甘油三酯(TG)降低,高密度脂蛋白膽固醇(HDL-C)升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);其余各項(xiàng)指標(biāo)與干預(yù)前比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);4)干預(yù)前后兩組差值比較:實(shí)驗(yàn)組在控制氧化應(yīng)激、血糖、血脂、人體測量學(xué)指標(biāo)方面優(yōu)于對照組(P0.05);5)相關(guān)性分析:超氧化物歧化酶與糖代謝指標(biāo)、體重指數(shù)、甘油三酯負(fù)相關(guān);與高密度脂蛋白膽固醇呈正相關(guān)。丙二醛與糖代謝指標(biāo)、體重指數(shù)、甘油三酯正相關(guān);與高密度脂蛋白膽固醇負(fù)相關(guān)。維生素E與高密度脂蛋白膽固醇成正相關(guān),與體重指數(shù)、肱三頭肌皮褶厚度呈負(fù)相關(guān)。維生素C與肱三頭肌皮褶厚度與呈負(fù)相關(guān)。以上結(jié)果均有統(tǒng)計(jì)學(xué)意義(P0.05);結(jié)論:T2DM患者體內(nèi)氧化應(yīng)激水平較高,且隨著血糖的水平的升高而逐漸升高。個(gè)性化飲食干預(yù)可改善患者營養(yǎng)素?cái)z入量及體內(nèi)氧化應(yīng)激狀態(tài),降低血糖水平,調(diào)節(jié)血脂,減輕或控制營養(yǎng)不良發(fā)生的風(fēng)險(xiǎn),對改善胰島素β細(xì)胞功能及胰島素抵抗?fàn)顟B(tài)有著眾多益處。同時(shí)可為新疆地區(qū)指導(dǎo)T2DM患者合理膳食、促進(jìn)生命質(zhì)量提供理論依據(jù)。
[Abstract]:Objective: 1) To understand the dietary status and oxidative stress level of T2DM patients in Xinjiang; 2) To evaluate the effects of individualized dietary intervention on nutritional risk, nutrient intake, oxidative stress index, glucose metabolism index, lipid metabolism index and anthropometric index of T2DM patients. From January 2016 to December 2016, 160 inpatients with T2DM were divided into control group and experimental group according to the method of random number table, each group had 80 cases. The control group was given health education of routine diet and diet intervention of traditional food exchange method, and the experimental group was given individualized diet intervention. Vitamin E content, evaluation of the body's anti-oxidative defense, glucose metabolism, lipid metabolism, and anthropometric indicators of changes, before and after the intervention to compare the improvement of indicators and correlation between the two groups of patients, analysis of differences in oxidative stress levels. Results: 1) Baseline survey results: two groups of patients in demographic data, disease status, camp. There was no significant difference in nutritional risk screening score (P 0.05); 2) Comparison between groups before and after intervention: Nutrient intake (carbohydrate, calcium, zinc, selenium, VC, VE), oxidative stress index (superoxide dismutase, vitamin C, vitamin E) and high-density lipoprotein cholesterol (HDL-C) were increased in the experimental group after intervention; Amount, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglyceride, total cholesterol, low-density lipoprotein cholesterol and anthropometry were reduced; compared with the control group, the difference was statistically significant (P Compounds, calcium, zinc, selenium, VC, VE, oxidative stress indicators (superoxide dismutase, vitamin C, vitamin E), high-density lipoprotein cholesterol indicators were significantly increased; energy, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglycerides, total cholesterol, low-density lipoprotein cholesterol and anthropometric indicators were reduced, the differences were unified. There was a significant difference between the control group and the control group (P 0.05). Glucose metabolism index and triglyceride (TG) decreased, high-density lipoprotein cholesterol (HDL-C) increased, the difference was statistically significant (P 0.05); the other indicators compared with the pre-intervention, there was no significant difference (P 0.05); 4) The difference between the two groups before and after intervention: experimental group in the control of oxidative stress, blood sugar, blood lipids, body measurement. Quantitative indicators were better than the control group (P 0.05); 5) Correlation analysis: superoxide dismutase and glucose metabolism indicators, body mass index, triglyceride negatively correlated; and high-density lipoprotein cholesterol was positively correlated. Malondialdehyde and glucose metabolism indicators, body mass index, triglyceride positively correlated; and high-density lipoprotein cholesterol negatively correlated. Vitamin C was negatively correlated with the thickness of triceps brachii skin fold. The above results were statistically significant (P 0.05); Conclusion: The oxidative stress level in T2DM patients was higher, and gradually increased with the increase of blood sugar level. It can improve the intake of nutrients and oxidative stress, reduce blood sugar, regulate blood lipids, reduce or control the risk of malnutrition, and has many benefits to improve insulin beta cell function and insulin resistance. It can also provide theoretical basis for guiding the rational diet of T2DM patients in Xinjiang and promoting the quality of life. According to it.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張莉;占瓊;趙軍;李建光;周源;楊歡杰;王寧;;新疆維吾爾族人群SLC22A1基因多態(tài)性頻率分布及糖尿病家族史對其突變的影響研究[J];中國全科醫(yī)學(xué);2017年05期

2 何帆;楊文君;李玉芳;;營養(yǎng)支持小組對維持性血液透析患者營養(yǎng)狀況的影響[J];新疆醫(yī)科大學(xué)學(xué)報(bào);2017年01期

3 韓菊紅;戴民;趙美華;;基于醫(yī)療聯(lián)合體對2型糖尿病患者健康管理的影響[J];中國健康教育;2016年12期

4 何利平;未友能;;維生素C和E對2型糖尿病血管內(nèi)皮功能的影響[J];檢驗(yàn)醫(yī)學(xué)與臨床;2016年21期

5 王巍;吳麗蘋;趙詠桔;曹久妹;;2型糖尿病家族史風(fēng)險(xiǎn)通路識別及功能分析[J];診斷學(xué)理論與實(shí)踐;2016年05期

6 孫夢菊;趙鵬飛;;量化飲食與運(yùn)動聯(lián)合血糖生成指數(shù)與糖尿病治療效果的臨床分析[J];實(shí)用糖尿病雜志;2016年04期

7 權(quán)卓;祁志芳;鄧雪玲;任長壽;賀澤鋒;;自我餐后血糖監(jiān)測達(dá)標(biāo)為2型糖尿病患者帶來的獲益影響[J];中國當(dāng)代醫(yī)藥;2016年14期

8 穆艷;許陳玉;;營養(yǎng)風(fēng)險(xiǎn)及營養(yǎng)支持對住院患者臨床結(jié)局的影響[J];護(hù)理學(xué)雜志;2016年05期

9 付曉杰;王璐;;糖尿病及其并發(fā)癥的臨床檢驗(yàn)探討[J];糖尿病新世界;2016年04期

10 張海峰;朱靜芬;馮易;梁辰;楊輝;施榕;;上海市社區(qū)2型糖尿病患者飲食控制現(xiàn)狀研究[J];中國全科醫(yī)學(xué);2015年34期

相關(guān)碩士學(xué)位論文 前1條

1 從繼妍;對2型糖尿病患者實(shí)施飲食連續(xù)護(hù)理干預(yù)的效果研究[D];天津醫(yī)科大學(xué);2012年

，

本文編號：2246471