营养治疗慢性肾功能衰竭效果的初步观察

在非透析综合疗法中膳食治疗的原则,应是在限制低蛋白质摄入量的基础上设法提高必需氨基酸的摄入水平,以纠正体内氨基酸代谢紊乱。根据此原则我们为慢性肾功能衰竭患者制备了低蛋白麦淀粉膳食(蛋白质限制在20～40g/24hr,总热量2000～3000kcal/24hr),麦淀粉含蛋白质量甚低(0.4—0.6g％),故以其代替大米,面粉做为主食,既可减少植物蛋白质的进量,又可在低蛋白限量范围内适当增加含必需氨基酸丰富的食品,如蛋,奶、瘦肉等;并使优质蛋白质占膳食中总蛋白质量的50～70％。本组30例病人经治疗1—2个月后,除6例(2例无效,4例因故未坚持治疗)外,病人氮质血症均有减轻,临床症状得到改善,营养状况有所改进,延长了生命,根据6例氮平衡实验结果,提示慢性肾衰病人(Ccr5—10ml/min)的饮食在充足热量摄入的基础上,蛋白质摄入量至少0.5g/kg/24hr,(其中优质蛋白占50—70％),才可达到氮的平衡。

PRELIMINARY REPORT ON THE NUTRITIONAL TREATMENT OF CHRONIC UREMIC PATIENTS

In non-dialytic composite treatment of chronic renal failure, wheat (or corn) starch should be used for low protein (20-40 g/day) diet in substituting grains, to increase high biological value protein intake (about 50-70% of total protein intake). This principle has been used in 30 Patients (33 times) for 1-2 monthes. Daily total calorie intake should be maintained within 2000-3000 kcal. According to the status of the patient, EAA-TR2 (13.8 g/day I.V.) and other supporting measurements may be used for most patients. In all the patients, except six (2 cases useless, observation of 4 cases discontinued), uremic manifestations were ameliorated, nutritional status was improved and azotemia markedly alleviated, life span may be prolonged. According to nitrogen balance studied, in 6 cases it is indicated that nitrogen balance can be maintained if protein intake is not less than 0.5 g/kg/day (with sufficient calorie intake) for chronic renal failure patients (Cr clearance 5-10 ml/min).