纠正酸中毒对维持血透患者营养状况的影响

摘要

Objective To explore the effect of oral sodium bicarbonate to correct acidosis for nutrional status in maintenance hemodialysis(MHD)patients.Methods Thrity maintenance hemodialysis patients with MA(predial-ysis HCO -3 <21 mmol/L)were enrolled.They were randomly divided into experimental group and control group.Pa-tients in experimental group were administred oral sodium bicarbonate.The nutritional parameters were assessed 3 months later.Results ① Comparison between two groups after intervention:The HCO -3 (P <0.05),serum BUN and phosphorus level were significantly higher in experimental group than those in group;②Comparison between be-fore and after intervention within the experimental group:Compared with baseline, the HCO-3, TSF, total serum cho-lesterol, percent of reticulocyte were increased significantly, while HDL decreased significantly after intervention(all P<0.05). Conclusion Oral sodium bicarbonate supplementation can effectively correct acidosis in MHD pa-tients, and the therapy may led to the improvement of nutritional status and anemia. Meanwhile, oral sodium bicar-bonate supplementation maybe lead to elevation of serum phosphorus and dyslipidemia.%目的：探讨口服碳酸氢钠纠正酸中毒对维持血透患者营养状况的影响。方法入选30例透析前 HCO -3≤21 mmol/L 的维持血液透析患者，随机分为观察组和对照组，观察组给予碳酸氢钠口服。3个月后比较两组间以及观察组干预前后营养指标。结果①组间比较：观察组实际碳酸氢根（AB）、血尿素氮（BUN）、血磷较对照组升高（P ＜0．05）；②观察组自身前后比较：干预后 AB（P ＜0．05）、肱三头肌皮褶厚度、网织红细胞比例、总胆固醇较干预前升高，高密度脂蛋白（HDL-C）较干预前降低（P ＜0．05）。结论口服碳酸氢钠治疗可以有效纠正维持性血液透析患者酸中毒并部分改善营养状况及贫血，但同时可能导致这部分人群血脂异常、血磷升高。