应用糖化血清蛋白监测甲亢患者蛋白质营养状态的可行性分析

目的探讨应用糖化血清蛋白监测甲亢患者蛋白质营养状态的可行性。方法从我院门诊和住院患者中收集43例甲状腺功能亢进患者血清标本为实验组,从健康体检人群中收集43例体检健康者血清标本为正常对照组,两组人群均上午空腹采静脉血。使用自动生化分析仪分别测定糖化血清蛋白(GSP)、血清前白蛋白(PA)、白蛋白(ALB)及总蛋白(TP)的含量。数据结果使用SPSS 17.0统计软件处理。结果甲亢患者GSP(1.47±0.45)mmol/L,PA(182±48.1)mg/L,ALB(43.2±3.4)g/L,TP(68.1±4.7)g/L;正常对照组GSP(1.77±0.17)mmol/L,PA(223±49.8)mg/L,ALB(45.3±1.8)g/L,TP(71.8±3.2)g/L。甲状腺功能亢进患者GSP,PA,ALB、TP分别低于正常对照组,差异有统计学意义(t分别是-3.565,-3.363,-3.356,-3.187,P均小于0.05);43例患者中有14例GSP(32.6%)、8例PA(18.6%)分别低于参考值下限,而TP和ALB各仅有1例低于参照值范围。相关分析结果,GSP与PA、ALB、TP的相关系数r分别是0.896,0.275,0.270,P分别是0.000,0.131,0.135。结论甲状腺功能亢进患者血清GSP水平显著降低,且与血清PA呈显著的正相关。血清GSP具备监测甲亢患者蛋白质营养状况的能力,是一项良好且敏感的指标。     

血清四项生化指标联合检测在狼疮肾炎患者早期肾损伤的临床意义

目的探讨血清尿素氮(BUN)、肌酐(Cr)、胱抑素C(Cy8C)和视黄醇结合蛋白(RBP)四项生化指标联合检测对狼疮肾炎(LN)的早期诊断价值。方法选择2011年1月~2016年4月陕西省人民医院收治并符合美国风湿病协会(ACR)2012年修订的SLE诊断标准并伴有肾脏病变的177例LN患者,同时选择167例健康体检者作为对照组。采用日立7170A全自动生化分析仪对两组血清BUN,Cr,CysC:和RBP浓度进行检测,所得数据用SPSS17.0统计软件进行统计分析。结果 LN患者组与健康对照组比较,血清BUN(6.67±1.43 mmol/L vs 6.57±1.16 mmol/L),Cr(96.9±10.1/μmol/L vs 92.6±13.2μmol/L),CysC(1.7±0.5 mg/L vs 0.75±0.15mg/L),RBP(180.5±8.28 mg/L vs 42.6±9.6 mg/L)浓度均升高,且血清CysC,RBP升高水平与健康对照组比较差异有统计学意义(t=8.145,21.594,均P0.05)。单项指标检测异常率方面,LN患者组血清BUN,Cr,CysC和RBP的异常率分别为28.3%,29.4%,68.4%和65.0%。四项指标联合检测异常率为85.3%,明显高于单项指标检测异常率(x~2=35.973~168.742,P0.01)。结论血清BUN,Cr,CysC和RBP四项生化指标联合检测对LN患者肾损伤的早期诊断具有重要意义。     

微炎症状态对维持性血液透析患者的影响及氟伐他汀的干预作用

目的 探讨微炎症状态对维持性血液透析(MHD)患者的影响及氟伐他汀的干预作用.方法 以2005年6月至2007年6月我院血液透析中心行MHD患者76例为研究对象.均在入组后第1天、6个月分别检测前白蛋白(PA)、ALB、BUN、Cr、TC、TG、HDL-C、LDL-C、脂蛋白a[Lp(a)]、转铁蛋白(SF)及超敏C-反应蛋白(hs-CRP)、IL-6、TNF-α.据CRP水平将患者分为炎症组(CRP≥8 mg/L)及非炎症组(CRP<8 mg/L).另设正常对照组30例,炎症组给予氟伐他汀治疗,非炎症组不给予氟伐他汀;观察时间为6个月.结果 与正常对照组比较MHD患者hs-CRP[(8.96±5.33)mg/L与(2.97±1.53)mg/L]、IL-6[(11.32±4.94)ng/L与(4.40±1.51)ng/L]、TNF-α[(15.89±6.20)ng/L与(9.62±3.45)ng/L]、TG[(2.98±1.36)mmol/L与(1.35±0.97)mmoL/L]、Lp(a)[(0.46±0.41)mg/L与(0.21±0.25)mg/L]、sF[(179.45±101.36)μg/L与(106.11±75.55)μg/L]水平明显升高(P<0.01或P<0.05);ALB[(35.02±4.83)g/L与(43.16±5.53)g/L]水平明显降低(P<0.01);炎症组心血管事件发生率明显高于非炎症组,且微炎症状态越明显,脂质代谢紊乱和营养不良越显著;炎症组较治疗前hs-CRP[(6.03±2.46)mg/L与(10.32±1.46)mg/L]、IL-6[(9.91±0.75)ng/L与(13.50±3.11)ng/L]、TG[(1.50±1.01)mmol/L与(3.05±1.55)mmol/L]、TC[(3.35±1.66)与(5.26±1.63)mmol/L]、LDL-C[(2.45±1.35)mmol/L与(3.46±1.36)mmol/L]、Lp(a)[(O.26±0.30)mmol/L与(0.50±0.31)mmol/L]水平明显降低(P<0.01或P<0.05),ALB[(38.16±4.63)g/L与(33.43±3.08)g/L]、HDL·C[(1.76±0.82)mmol/L与(0.96±0.58)mmol/L]明显升高(P均<0.05).结论 MHD患者普遍存在微炎症状态及血清脂质代谢紊乱和营养不良,微炎症反应状态对MHD患者心血管事件发生率及血清脂质代谢紊乱和营养不良起着重要的作用;氟伐他汀具有改善MHD患者微炎症反应状态的作用,其抗炎作用独立于调脂作用之外;早期发现及干预治疗微炎症反应状态对改善MHD患者的预后具有十分重要的意义.     

经口间歇置管肠内营养对脑卒中吞咽障碍老年患者血清营养学指标及吞咽功能的影响

目的探究经口间歇置管肠内营养对脑卒中(cerebral stroke,CS)老年患者的营养状态及吞咽障碍的影响。方法回顾性选取鹤壁市人民医院2017年9月至2019年9月收治的125例CS吞咽障碍老年患者作为研究对象,根据制定的方案不同分为对照组和观察组。对照组予冰酸咽部刺激和常规饮食管理,观察组增加经口间歇置管肠内营养,对比两组血清营养学指标、吞咽功能。结果观察组治疗1个月末血清血清白蛋白(ALB)(43.19±3.56)g/L、转铁蛋白(TRF)(2.36±0.43)g/L、前白蛋白(PA)(281.53±42.94)mg/L水平及吞咽困难评价量表(VFSS)评分(8.69±0.52)分高于对照组(39.57±2.92)g/L、(1.89±0.35)g/L、(234.62±46.13)mg/L、(6.97±1.24)分;洼田饮水试验(1.32±0.11)分、吞咽功能评估法(SAA)评分(18.45±2.36)分低于对照组(4.13±0.27)分、(29.37±2.92)分(P0.05)。结论经口间歇置管肠内营养可通过提高CS感觉神经纤维的兴奋性以改善CS吞咽困难患者的血清营养学指标,调节吞咽功能。     

护理干预联合肠内营养对神经内科肠功能障碍患者预后的影响

目的探讨护理干预联合肠内营养对神经内科肠功能障碍患者预后的影响。方法选择2011年7月至2012年6月神经内科肠功能障碍的120例重症患者,将患者分为对照组58例与观察组62例,对照组进行肠内营养与常规护理,观察组在常规护理的基础上进行肠内营养的营养液输注与并发症护理。观察两组患者的病程、治愈率、病死率、后遗症以及并发症,并检测血清总蛋白(TP)、血清白蛋白(ALB)以及血清前蛋白(PA)的变化。结果观察组持续病程(55.2±8.3)d,明显短于对照组的(87.7±10.5)d,两组比较差异有统计学意义(t=-18.872,P<0.05);观察组治愈率为95.2%,对照组为6.2%,两组比较差异有统计学意义(x~2=77.235,P<0.05);观察组病死1例(1.6%),后遗症6例(8.6%),明显低于对照组(5,13例),两组比较差异有统计学意义(x~2=5.062,5.985;P<0.05)。观察组发生上消化道出血0例,电解质紊乱5例,肝肾功能损害2例,神经功能损害10例,与对照组比较(分别为9,16,10,23例),差异均有统计学意义(x~2值分别为10.401,7.910,6.541,8.319;P<0.05)。观察组治疗后TP、ALB、PA含量明显较治疗前提高,与对照组比较[(68.2±2.3)/(61.5±2.1)g/L,(36.8±2.1)/(31.7±2.0)g/L,(251.8±30.01)/(173.1±27.6)mg/L],差异具有统计学意义(t值分别为14.149,12.842,10.792;P<0.05)。结论护理干预联合肠内营养科有效缩短患者病程,提高治愈率,降低病死率及并发症,并有效提高TP、ALB及PA的含量。     

104例系统性红斑狼疮患者血清指标的变化及C1q抗体的表达

目的检测系统性红斑狼疮(SLE)患者血清指标及C1q抗体(Anti-C1q)的变化,并探讨其临床意义。方法选取104例SLE患者(SLE组)及100例体检健康者(健康对照组)作为研究对象,检测其血清中Anti-C1q、双链DNA(dsDNA)抗体、其他相关自身抗体及生化指标,并对结果进行分析。结果与健康对照组相比,SLE组的三酰甘油(TG)水平升高[(3.89±0.65)mmol/L vs.(1.12±0.48)mmol/L,P0.05],高密度脂蛋白(HDL)水平降低[(0.8±0.2)mmol/L vs.(1.2±0.3)mmol/L,P0.05],超敏C反应蛋白(hs-CRP)水平升高[(5.5±1.4)mg/L vs.(0.9±0.6)mg/L,P0.05],补体C3水平降低[(87.6±14.7)mg/L vs.(128.2±20.3)mg/L,P0.05],补体C4水平降低[(16.2±4.8)mg/L vs.(29.1±7.4)mg/L,P0.05]。SLE组Anti-C1q水平较健康对照组明显升高[(44±20)U/mL vs.(6.5±1.8)U/mL,P0.05],其中活动期SLE患者Anti-C1q水平明显高于非活动期患者(P0.05),狼疮性肾炎(LN)患者Anti-C1q水平明显高于非LN患者(P0.05),dsDNA抗体阳性者Anti-C1q水平明显高于dsDNA抗体阴性者(P0.05)。结论 SLE患者外周血中各种生化指标和自身抗体的异常为患者疾病诊断提供了一定的理论依据,其中Anti-C1q的异常表达更有助于对活动期SLE和LN的诊断。     

中药离子导入治疗糖尿病肾病的效果分析

目的观察分析中药离子导入治疗糖尿病肾病的临床效果。方法回顾性分析108例糖尿病肾病患者的病例资料,根据治疗方案不同分为对照组和观察组,其中对照组52例。对照组采用常规疗法,观察组在常规疗法基础上采用中药离子导入疗法。分析比较两组患者治疗前后尿清蛋白、尿素氮、血清肌酐、内生肌酐清除率指标、三酰甘油、胆固醇的变化。结果观察组经治疗后尿微量清蛋白(UAE)由(91±14)mg/24 h降至(42±7)mg/24 h,水平明显降低,差异有统计学意义(P0.001);血清肌酐由(6.64±1.55)mmol/L降至(7.43±0.99)mmol/h,水平明显降低,差异有统计学意义(P=0.002);三酰甘油由(1.96±0.32)mmol/L降至(1.30±0.30)mmol/L,水平明显降低,差异有统计学意义(P0.001);胆固醇由(6.34±1.35)mmol/L降至(4.43±0.30)mmol/L,水平明显降低,差异有统计学意义(P0.001);对照组治疗前后尿微量清蛋白、尿素氮、血清肌酐、内生肌酐清除率水平、三酰甘油水平、胆固醇水平均差异无统计学意义(P0.05)。结论中药离子导入疗法能够有效降低糖尿病肾病患者的尿清蛋白、血清肌酐水平,延缓慢性肾衰的进程,且可改善脂代谢。     

513例健康妊娠妇女血清Cys-C、BUN、Cr水平的分析

目的分析513例健康妊娠妇女不同孕周血清胱抑素C(Cys-C)、尿素氮(BUN)、肌酐(Cr)水平,为妊娠期妇女肾功能改变提供依据。方法选取513例健康妊娠妇女,按不同孕周分为早、中、晚孕3组,并随机选取44例未孕女性健康体检者作对照组,4组受检者分别检测血清Cys-C、BUN、Cr水平。结果早、中、晚孕及对照组血清Cys-C水平分别为(0.57±0.09)mg/L、(0.59±0.10)mg/L、(0.97±0.21)mg/L和(0.76±0.09)mg/L;BUN水平分别为(2.99±0.85)mmol/L、(2.91±0.79)mmol/L、(3.29±0.90)mmol/L和(4.51±1.00)mmol/L;Cr水平分别为(45.24±7.04)μmol/L、(42.83±6.79)μmol/L、(48.55±8.75)μmol/L和(62.13±6.45)μmol/L。各组间Cys-C、BUN、Cr水平两两比较,除早、中孕两组Cys-C和BUN水平比较差异无统计学意义(P0.05),其余各组间两两比较差异均有统计学意义(P0.05)。结论血清Cys-C与BUN、Cr水平在不同孕周变化不一致,Cys-C随着孕周的增加而逐渐升高,晚孕期超过健康成人水平,提示临床医生评价肾功能时,应考虑妇女妊娠期的特殊性。     

坎地沙坦联合复方丹参滴丸治疗2型糖尿病Ⅲ期肾病效果观察

目的 观察坎地沙坦与复方丹参滴丸联合治疗2型糖尿病Ⅲ期肾病的疗效.方法 选择2型糖尿病肾病Ⅲ期患者60例,随机分为治疗组和对照组各30例.治疗组:坎地沙坦4 mg,1次/d,复方丹参滴丸15粒,3次/d,疗程3个月.对照组:坎地沙坦4 mg,1次/d,疗程3个月.两组均于受试前、后测定尿微量白蛋白,血清尿素氮(BUN)和血肌酐(Cr).结果 两组在受试3个月后与治疗前比较尿微量白蛋白及BUN、Cr均有降低,治疗组明显优于对照组[治疗组差值分别为(-14.6±8)mg/L、(-11.9±3.3) μmmol/L、(-0.7±0.2)mmol/L,对照组为(-7.1 ±7.8)mg/L、(-8.5±0.8)μmol/L、(-0.4 ±0.1)mmol/L],差异有统计学意义(t值分别为2.213、2.206、2.203、2.302,P＜0.05或P＜0.01).结论 坎地沙坦联合复方丹参滴丸能良好的降低2型糖尿病Ⅲ期肾病患者的尿微量白蛋白及血清尿素氮和血肌酐.     

血清胱抑素C检测在新生儿缺氧缺血性脑病肾功能评估的临床应用

目的探讨血清胱抑素C(Cys C)检测在新生儿缺氧缺血性脑病(HIE)肾功能评估中的临床应用。方法HIE组65例,对照组65例,两组均于生后24 h内采集静脉血2 ml,进行血清Cys C、尿素氮(BUN)和肌酐(Scr)检测;HIE组在治疗1周后再次采集静脉血2 ml,进行血清Cys C检测。并将结果进行分析。结果 HIE组的Cys C(2.35±0.28)mg/L,高于对照组的(1.34±0.31)mg/L,差异有统计学意义(P0.01),HIE组BUN和Scr检测结果分别为(5.10±1.36)mmol/L和(51.4±6.3)μmol/L,对照组BUN和Scr检测结果分别为(4.81±1.25)mmol/L和(49.5±5.8)μmol/L,两组相比较,差异无统计学意义(P0.05)。HIE组中轻、中、重度三小组入院时血清Cys C分别为(1.92±0.46)mg/L、(2.39±0.67)mg/L和(3.45±0.86)mg/L,治疗一周后血清Cys C分别为(1.36±0.59)mg/L、(1.84±0.58)mg/L和(3.16±0.71)mg/L,其中轻度和中度HIE小组的Cys C下降较明显,较入院时差异均有统计学意义(P0.01,P0.05)。重度HIE小组的血清Cys C治疗前后差异无统计学意义(P0.05)。结论血清Cys C检测可作为新生儿HIE患儿早期肾功能的评价指标,为早期肾功能损害的诊治提供依据,另外也可用于HIE患儿治疗后肾功能恢复情况的评估。     

Association between dietary patterns and sociodemographics: A cross‐sectional study of Australian nursing students

Lack of time, financial issues, and stressful clinical and educational environments in nursing studies promote higher intakes of convenience and fast foods loaded with fat and sugar, which are linked to reduced mental and physical health. In this study, we examined the dietary patterns of nursing students and their associated sociodemographic factors to inform the development of future health‐promotion interventions. A total of 548 Bachelor of Nursing students were invited to complete a survey. Associations were explored using χ² and logistic regression. Three dietary patterns were identified: healthy (fruit, vegetables, and legumes), Western (loaded with fat, sugar, and salt), and unbalanced. Only 21% of participants were classified as following a healthy dietary pattern, and more likely to be older (>35 years old) and have a personal annual income between $AUD20 000–$59 999 and $60 000–$99 999. Students with one to two and three or more children were more likely to follow a Western dietary pattern. There is a need to develop interventions to improve the dietary behaviors of nursing students by health‐promoting activities and the provision of online health resources.     

Psychosocial factors associated with diet quality in a working adult population

The associations between specific intra‐ and inter‐personal psychosocial factors and dietary patterns were explored in a healthy, working adult sample of university and health center employees (N = 640) who were enrolled in a prospective predictive health study. Participants had a mean age of 48 (SD = 11) years and were 67% women and 30% minority. Baseline psychosocial measures of perceived stress, depressive symptoms, social support, and family functioning were examined for their relationships with three diet quality indices—AHEI, DASH, and the Mediterranean. Dietary intake was of moderate quality in this high‐income, well‐educated, psychosocially healthy population. Social support was positively associated with better diet quality for all three indices (p < .01). Further research should focus on socio‐environmental factors associated with diet quality. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36:242–256, 2013     

应用食物模型进行糖尿病饮食教育的效果观察

[目的]探索一种较好的糖尿病饮食教育形式。[方法]将120例糖尿病病人随机分为观察组和对照组,分别采用相同内容和不同形式(食物模型及口头、文字、图片)对糖尿病病人进行糖尿病饮食教育。通过问卷调查及检测血糖变化,观察教育效果。[结果]在接受教育6个月后,观察组对食物的量化指标认知程度、理论知识、动手操作能力、空腹血糖和餐后2h血糖变化与对照组比较,差异均有统计学意义(P<0.05或P<0.01)。[结论]应用食物模型进行糖尿病饮食教育,便于病人理解和实践,有利于血糖控制,是较好的饮食教育形式。     

饮食随访管理在老年糖尿病院外饮食控制中的应用研究

目的探讨饮食随访管理对老年糖尿病患者院外饮食控制中的应用效果。方法将84例老年糖尿病患者随机分为2组各42例,对照组出院后不予以干预,观察组出院后实施饮食随访管理,比较2组的院外饮食方式、血糖控制情况及生活质量。结果 2组患者出院时的饮食知识、方式评分,血糖水平以及生活质量各项评分均无统计学意义(P0.05);观察组干预后的饮食知识、行为得分差值大于对照组,FBG、P2h BG的差值大于对照组,差异有统计学意义(P0.05)。结论饮食随访管理能够增加老年糖尿病患者的饮食知识,改善饮食行为,提高血糖控制水平,改善生活质量。     

Structured weight-loss programs: Meta-analysis of weight loss at 24 weeks and assessment of effects of intervention intensity

Obesity is increasing in epidemic proportions globally while current therapies continue to be suboptimal. In this investigation, weight loss in obese individuals after 24 weeks with different nutrition interventions was compared. The impact of intervention intensity was assessed. Inclusion criteria were established and a comprehensive literature review was performed. These nutrition interventions were identified and analyzable: meal replacements (MRs); energy-restricted (>1500 kcal/d) diets (ERDs); low-energy (800–1500 kcal/d) diets (LEDs); soy very low energy (<800 kcal/d) diets (VLEDs) referred to as SOYs; and VLEDs. Intensity was assessed using the following parameters: physician visits, clinic visits, and hours of class over 24 weeks; an intensity score represents an adjusted sum of the values. Weight losses at 24 weeks as percentage of baseline weights (95% confidence intervals) were as follows: MRs, 9.1% (5.7–12.5); ERDs, 8.5% (4.9–12.1); LEDs, 11.4% (8.9–13.1); SOYs, 16.5% (13.9–19.1); and VLEDs, 21.3% (20.1–22.5). Weight loss with SOYs was significantly greater than with MRs and ERDs; weight loss with VLEDs was significantly greater than with any other diet. Energy intake was the most significant (P<.0001) regression variable related to weight loss; however, the intensity of intervention (P=.0003) was significantly stronger than initial body weight or duration of treatment. Medically supervised VLEDs are the most effective intervention for facilitating substantial weight loss over 24 weeks. SOY may promote more rapid weight loss over the first 8 weeks than other interventions. MRs appear to be equally effective with ERDs and LEDs with lower levels of intervention intensity.     

Effects of hypocaloric very‐low‐carbohydrate diet vs. Mediterranean diet on endothelial function in obese women*

Background Obesity is a cardiovascular risk factor associated with endothelial dysfunction, but the effect of different weight loss strategies on endothelial function is not known. The effect of diet on endothelial function in two hypocaloric diets, a very‐low‐carbohydrate diet (A) and a Mediterranean diet (M), was measured by brachial artery flow‐mediated dilation (FMD). Design Using a longitudinal, randomized, open study design, subjects were engaged in a 2‐month weight loss diet. FMD, inflammatory cytokines [interleukin‐6 (IL‐6) and tumour necrosis factor‐α] and a marker of oxidative stress [8‐iso‐prostaglandin F2α (8‐iso‐PGF2α)] were measured in subjects on three occasions: before initiating the diet (T0), after 5–7 days of dieting (T5) and after 2 months of dieting (T60). The very short‐ and medium‐term time points were established to discriminate respectively the effect of the diet itself (T5) from that of weight loss (T60). Twenty overweight/obese but otherwise healthy women (BMI: 27–34·9 kg m^?2; age 30–50 years) completed the study. Results Group A lost more weight (mean ± SEM; ?7·6 ± 0·8 kg) than group M (?4·9 ± 0·6 kg, P = 0·014) at T60. The FMD was not significantly different between the two groups at T0 (group A: 12·2 ± 2·9% vs. group B: 10·3 ± 2·3%, P = ns). In group A, FMD was significantly reduced at T5 and returned to baseline at T60; in group M, FMD increased at T5 and returned to baseline at T60 (P = 0·007 for diet × time interaction). Serum concentrations of IL‐6 and 8‐iso‐PGF2α were not significantly different between the two groups at T0 and increased significantly at T5 only in group A (P < 0·001 and P < 0·005 respectively). Conclusion As endothelial dysfunction is known to be associated with acute cardiovascular events, this study suggests that the cardiovascular risk might be increased in the first days of a very‐low‐carbohydrate diet.     

肥胖症患者袖状胃切除术的饮食护理与指导

目的探讨肥胖症患者袖状胃切除术的饮食护理及术后饮食指导,以保证患者围术期安全,提高手术疗效及患者术后生活质量。方法对2010年1月至2011年12月在第二军医大学长海医院微创外科实施腹腔镜下袖状胃切除术(laparoscopic sleeve gastretomy,LSG)的82例肥胖症患者进行规范的围术期饮食护理及指导,术后定期进行营养跟踪教育。结果所有病例均顺利康复出院,并进行至少12个月的术后随访,体质量下降显著,相关并发症亦有不同程度改善。随访期内有15例患者出现脱发症状,其中1例较为严重,经饮食调整或药物治疗后均获不同程度缓解;所有病例均未见其他明显营养相关并发症。结论规范合理的饮食护理和指导是保证手术疗效、减少围术期并发症、避免术后营养相关并发症并提高患者生活质量的重要因素,值得临床推广应用。     

10例半乳糖血症患儿的护理

对10例半乳糖血症患儿的护理进行了总结和分析,针对半乳糖血症患儿的黄疸、低血糖、胃肠道症状及出血倾向等症状提出相应的护理措施。强调饮食治疗的重要性,同时注意饮食治疗前后胃肠道症状及黄疸的变化,做好治疗前各种检验标本的收集,争取早期诊断、早期治疗,降低此类患儿的伤残率。出院时教育家长给非乳类饮食,补充足够的蛋白质并及时添加辅食。