内科

目的观察复方α-酮酸治疗对糖尿病并发慢性肾衰竭血液透析患者血糖水平和营养状态的影响。方法选择60例行持续血液透析治疗的糖尿病并发慢性肾衰竭患者为研究对象，应用随机数字表法将其分为对照组和观察组，每组30例。对照组行常规药物治疗和饮食干预，观察组在对照组基础上加用复方α-酮酸治疗，两组患者均治疗3个月。比较两组患者治疗前后血糖水平［空腹血糖、血清糖化血红蛋白（HbA1c）］、营养状态［血清血红蛋白、血清前白蛋白、血清白蛋白、营养不良-炎症评分（MIS）、主观综合营养评估（SGA）评分］、肾功能（尿素清除指数）。结果治疗前，两组患者的空腹血糖、血清HbA1c水平差异均无统计学意义（均P＞0.05）；治疗3个月后，两组患者的空腹血糖水平差异无统计学意义（P＞0.05），观察组的血清HbA1c水平低于对照组（P＜0.05）。治疗前，两组患者的血清血红蛋白水平、血清前白蛋白水平、血清白蛋白水平、MIS、SGA评分差异均无统计学意义（均P＞0.05）；治疗3个月后，观察组的血清血红蛋白、前白蛋白、白蛋白水平均高于对照组，MIS、SGA评分均低于对照组（均P＜0.05）。两组患者治疗前后的尿素清除指数差异均无统计学意义（均P＞0.05）。结论复方-α酮酸治疗可改善糖尿病并发慢性肾衰竭血液透析患者血糖水平和营养状态。

ObjectiveTo observe the effects of compound α-ketoacid therapy on blood glucose levels and nutritional status of hemodialysis patients with diabetes complicated with chronic renal failure. MethodsA total of 60 patients with diabetes complicated with chronic renal failure undergoing continuous hemodialysis treatment were selected as research subjects, and they were divided into a control group or an observation group by the random number table method, with 30 cases in each group. The control group received conventional drug treatment and dietary intervention, based on which the observation group was given compound α-ketoacid therapy additionally, and both groups were treated for 3 months. The blood glucose levels (fasting glucose, serum hemoglobin A1c ［HbA1c］), nutritional status (serum hemoglobin, serum prealbumin, serum albumin, malnutrition-inflammatory score ［MIS］, subjective global assessment ［SGA］ score), and renal function (urea clearance index) before and after treatment were compared between the two groups. ResultsBefore treatment, there was no statistically significant difference in fasting glucose or serum HbA1c level between the two groups (all P＞0.05), and after 3 months of treatment, there was no statistically significant difference in fasting glucose level between the two groups (P＞0.05), but the serum HbA1c level in the observation group was lower than that in the control group (P＜0.05). Before treatment, there was no statistically significant difference in the serum hemoglobin level, serum prealbumin level, serum albumin level, MIS or SGA score between the two groups (all P＞0.05); after 3 months of treatment, the serum hemoglobin, prealbumin and albumin levels in the observation group were higher than those in the control group, and the MIS and SGA score were lower than those in the control group (all P＜0.05). There was no statistically significant difference in the urea clearance index between the two groups before and after treatment (all P＞0.05). ConclusionThe compound α-ketoacid therapy can improve blood glucose levels and nutritional status of hemodialysis patients with diabetes complicated with chronic renal failure.