【摘要】目的采用微营养评定简表法(mini nutritional assessment-Short form，MNA-SF)，探讨复方α酮酸对透析患者营养不良的改善作用。方法调查在150 家医院的透析中心接受血液透析(HD)或持续非卧床腹膜透析(CAPD)的终末期肾衰竭(ESRD)患者共2252 例，透析时间均在3 个月以上，所有患者均口服开同6 个月，以服用开同前营养状况作为对照。营养监测采用MNA-SF 方法结合客观指标测量：体质量指数(BMI)、三头肌皮褶厚度(TSF)、上臂围(AMC)、血清白蛋白(ALB)，统计采用Frideman 检验和配对秩和检验的方法。结果服用复方α酮酸制剂6 个月后，MNA-SF 评分由11.13±2.35 升至12.44±1.58，有显著差异；营养不良和营养不良风险例数分别由181 例(8.04%)和952 例(42.27%)降至33 例(1.48%)和474 例(21.24%)。体质指数从(21.86±3.38)kg/m2升至(22.18±3.32)kg/m2，血清白蛋白由(35.93±5.31)g/L 升至(38.27±5.04)g/L，有显著差异。三头肌皮褶厚度、上臂围和淋巴细胞计数等指标亦有明显上升。结论复方α酮酸制剂能够提高透析患者血白蛋白水平和体质指数，改善营养不良状况。

【Abstract】Objective This study aimed to explore the effect of compound α-ketoacids on the dialysis patients with malnutrition assessed by Mini Nutritional Assessment - short form (MNA-SF). Methods We investigated 2,252 patients who suffered from end-stage renal disease (ESRD) in the dialysis centers of 150
hospitals. These patients were treated with hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) for more than 3 months and compound α-ketoacids tablets orally for 6 months. The nutrition status before taking compound α-ketoacids tablets was used as control group. MNA-SF method combined with objective indexes including body mass index (BMI), triceps skinfold (TSF), mid-arm circumference (AMC), serum albumin (ALB) were used for monitoring nutrition status. Frideman test and paired rank test were used for statistical analyses. Results After 6 months of oral compound α-ketoacids treatment, MNA-SF score increased from 11.13±2.35 to 12.44±1.58 (P＜0.001), and the number of malnutrition and risk of malnutrition cases decreased from 181 patients (8.04%) and 952 cases (42.27%) to 33 patients (1.48%) and 474 cases (21.24%), respectively. BMI rose from 21.86±3.38 kg/m2 to 22.18±3.32 kg/m2 and serum ALB from 35.93± 5.31 g/L to 38.27±5.04 g/L, with statistical differences. TSF, AMC and lymphocyte count also increased obviously. Conclusion Compound α- ketoacids supplement could increase serum ALB and BMI and improve malnutrition status in dialysis patients.