去蛋白大米治療晚期慢性腎臟病患者的安全性、有效性的前瞻性對照研究
[Abstract]:Objective To study the compliance, safety and efficacy of deproteinized rice to the treatment of patients with advanced chronic kidney disease. Methods 41 cases of advanced chronic kidney disease (CKD) were included in the outpatient department of Guangzhou Red Cross Hospital from October 2014 to January 2016, and 36 of them had completed 12-month follow-up treatment. The random number table method was divided into 2 groups, the deproteinized protein rice (DPR) group and the wheat starch group as control (control, Conr) group. The nutrition education was carried out in both groups, a-keto acid (0.12g/ kg/ day) was given, and the protein intake was adjusted to 0.6 g/ kg/ day on the basis of sufficient heat (30-35kcal/ kg/ d), and the follow-up time was 0, 1, 3, 6, and 12 months. The follow-up recorded the patient's diet, complaints, general information, blood routine, blood biochemistry, hypersensitive C-reactive protein (HsCRP), parathyroid hormone (PTH), urea nitrogen, 24-hour urine protein, and therapeutic agent. To evaluate the efficacy of changes in glomerular filtration rate (eGFR), blood myoglobin, blood urea nitrogen, urinary protein and other biochemical indicators; to evaluate the safety in nutritional status; to intake energy in accordance with the criteria, The proportion of protein and the adherence to the persistent low-protein diet (LPD) were evaluated. Results (1) The baseline values of the two groups included basic disease composition ratio, age, sex, body weight, body weight index (BMI), hemoglobin, eGFR, myoglobin, urea nitrogen, uric acid, 24-hour urine protein, caloric intake, HsCRP, and no statistically significant difference in the use of the drug. Data matching. No significant adverse reactions were seen in the complete follow-up. (2) There was no significant difference between the two groups (p0.05). There was no significant difference in the level of heat in the two groups (p0.05). 90% of the patients in the DPR group insisted on low-protein diet therapy, and 86% of the patients in the Conr group insisted on low-protein diet treatment without statistical difference (P0.05). The ratio of the protein intake to the target value was significantly higher in the DPR group (83%) than in the Conr group (33%) (P0.05). (3) The eGFR of the DPR group was significantly higher in the DPR group than in the control group (P0.05). There was no statistical difference between the two groups (P0.05), but there was no statistical difference between the two groups (P0.05). However, there was no statistical difference (P0.05), but there was no statistical difference before the treatment (P0.05). The eGFR of the conr group was lower than that before the treatment (P0.05). After the treatment, the blood muscle strength and the blood urea nitrogen increased significantly (P0.05), and the uric acid increased before the treatment. There was no statistical difference (P0.05). (4) The 24-hour urinary protein in the DPR group was significantly lower than that in the control group (P0.05). The 24-hour urinary protein in the DPR group was significantly lower than that before the treatment (P0.05). (5) The binding force of carbon dioxide in the DPR group after the third month was significantly higher than that in the Conr group (P0.05); the carbon dioxide binding force in the DPR group decreased before the treatment, but there was no statistical difference (P0.05); and the carbon dioxide binding force in the Conr group was significantly lower than that before the treatment (P0.05). (6) After the third month of the DPR group, the serum calcium was significantly higher than that of the Conr group (P0.05). The blood phosphorus in the treatment group was significantly lower than that of the control group (P0.05), and there was no significant difference between the two groups (P0.05). In the treatment of the DPR group, the blood calcium was significantly higher than that before the treatment (P0.05), and the blood phosphorus was not significantly increased (P0.05). There was no significant increase in PTH (P0.05). There was no significant change before and after the treatment of serum calcium in the Conr group (P0.05). (7) There was no statistical difference between the two groups (P0.05). (8) In the two groups of DPR and Conr group, the body weight, BMI, serum albumin, serum prealbumin, triglyceride, cholesterol and hemoglobin remained relatively stable and there was no statistical difference (P0.05). Conclusion 1. Deproteinized rice can improve the compliance of patients with advanced CKD with low-protein diet. Deproteinized rice can delay advanced CKD progression. The deproteinized rice can reduce the urinary protein of patients with advanced CKD, improve the metabolic acidosis and the metabolism of calcium and phosphorus. The deproteinized rice has good safety in the treatment of advanced CKD patients.
【學位授予單位】：暨南大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R692
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