【摘要】目的探讨血液透析途中给予高蛋白饮食对患者营养指标的影响。方法对维持血液透析(maintenance hemodialysis，MHD)患者200 例进行调查，对符合纳入标准的低蛋白血症(血浆白蛋白＜40g/L)患者53 例，根据每周血液透析时间分为对照组(周一、三、五治疗患者，26 例)和高蛋白饮食干预组(周二、四、六治疗患者，27 例)。观察高蛋白饮食干预前后患者营养指标的变化情况。结果干预组患者在随访3 个月结束时，与组内基线和对照组比较，患者血浆白蛋白水平均明显升高(t/Z 值分别为3.493，-3.851；P 值分别为＜0.001,＜0.001)。干预组中基线标准化蛋白分解率(normalized protein catabolic rate,nPCR)＜1.0g/(kg·d)的11 例患者，随访结束时7 例(64%)患者nPCR＞1.0g/(kg·d)，差异具有统计学意义(t=-5.267, P＜0.001)。干预组患者随访结束时二氧化碳结合力较基线水平下降(t=3.667 P=0.001)，而血尿素氮较基线水平明显上升(t=-2.885 P=0.008)。结论煮熟鸡蛋清+袋装牛奶食谱价格低廉、实施简单安全方便，可短期内改善MHD 患者低白蛋白血症，值得在临床上推广应用。

【Abstract】Objective The aim of this study was to evaluate the effect of intradialytic protein-rich meals (egg + milk) on nutritional parameters in maintenance hemodialysis (MHD) patients. Method This was a single center and non-randomized study. Fifty-three patients with hypoalbuminemia (plasma albumin ＜40g/L) were assigned into control group (hemodialysis on Monday, Wednesday and Friday; n=26) or intervention group (hemodialysis on Tuesday, Thursday and Saturday; n=27). The control group received standardized nutritional counseling, and the intervention group received standardized nutritional counseling plus intradialytic protein-rich meal three times a week. They were observed for 3 months. Biochemical and body composition parameters were examined in both groups. Results In the invention group, compared with baseline and control
group, serum albumin increased significantly after intervention for 3 months (t/Z=3.493, - 3.851;P＜0.001, ＜0.001). In the intervention group, baseline normalized protein catabolic rate(nPCR) ＜1.0g/(kg •d) was found in 11 patients; at the end of the intervention, nPCR was increased significantly[＞1.0g/(kg•d)] in 7(64%)of them（t=-5.267, P＜0.001). After the intervention, CO2-CP decreased (t=3.667,P=0.001) and blood urea nitrogen increased (t=-2.885,P=0.008) as compared with the baseline values. Conclusions Intradialysis protein-rich meals improved serum albumin level in MHD patients.