CN110897153A - Nutritional preparation suitable for patients with kidney disease dialysis - Google Patents

Nutritional preparation suitable for patients with kidney disease dialysis Download PDF

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CN110897153A
CN110897153A CN201911176843.6A CN201911176843A CN110897153A CN 110897153 A CN110897153 A CN 110897153A CN 201911176843 A CN201911176843 A CN 201911176843A CN 110897153 A CN110897153 A CN 110897153A
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fatty acid
oil
vitamin
protein
nutritional formulation
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CN110897153B (en
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邢艳芳
孙健
张旗
陶秀梅
陈鹏
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Beijing Nuobao Nutrition Technology Co ltd
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Beijing Nukangda Medicine Polytron Technologies Inc
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    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/40—Complete food formulations for specific consumer groups or specific purposes, e.g. infant formula
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/115—Fatty acids or derivatives thereof; Fats or oils
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
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    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/125—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives containing carbohydrate syrups; containing sugars; containing sugar alcohols; containing starch hydrolysates
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/15—Vitamins
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
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    • A23L33/15—Vitamins
    • A23L33/155—Vitamins A or D
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/16—Inorganic salts, minerals or trace elements
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/17—Amino acids, peptides or proteins
    • A23L33/175—Amino acids
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
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    • A23L33/19—Dairy proteins
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
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    • A23L33/20—Reducing nutritive value; Dietetic products with reduced nutritive value
    • A23L33/21—Addition of substantially indigestible substances, e.g. dietary fibres
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    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
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    • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs

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Abstract

The invention belongs to the technical field of functional foods, and particularly relates to a nutritional preparation suitable for patients with renal disease dialysis, which comprises protein, lipid, carbohydrate and dietary fiber; wherein the energy supply ratio of the protein, the lipid, the carbohydrate and the dietary fiber is respectively 12-16%, 25-30%, 52-58% and 1-5%; the energy supply ratio of saturated fatty acid in the lipid is less than 10%, the energy supply ratio of monounsaturated fatty acid is 8-22%, and the energy supply ratio of polyunsaturated fatty acid to saturated fatty acid is more than 2; the mass ratio of L-carnitine to L-glutamine in the protein is 1: 1-1.5. The invention provides a compatible nutritional preparation according to the metabolism characteristics of a long-term kidney dialysis patient, can effectively improve protein energy malnutrition of the patient, reduces sugar metabolism abnormality and ester metabolism abnormality of the dialysis patient, and obviously improves the nutrition condition and immunity of the patient.

Description

Nutritional preparation suitable for patients with kidney disease dialysis
Technical Field
The invention belongs to the technical field of functional foods, and particularly relates to a nutritional preparation suitable for patients with kidney disease dialysis.
Background
Studies have shown that patients undergoing maintenance dialysis develop malnutrition in a proportion of about 58.33%, and patients with malnutrition have a further decline in dialysis efficiency, with severe cases even leading to short-term death. Optimizing the nutritional status of dialysis patients is the key to improve clinical treatment effect, and selecting a reasonable nutritional preparation is the hot spot and difficulty of clinical research at present.
Protein Energy Malnutrition (PEM) is a common disease in end-stage renal disease (ESRD) dialysis patients and is an independent risk factor for death in hemodialysis patients. Abnormal glucose metabolism in hemodialysis patients is mainly manifested by two conditions, namely impaired glucose tolerance and hypoglycemia, wherein the former is more common and the latter is less common. Hyperlipidemia is quite common in dialysis patients, with most patients exhibiting mild to moderate hypertriglyceridemia, and a few patients exhibiting mild hypercholesterolemia, or both.
In addition, the dialysis patients have reduced clearance of potassium, magnesium, phosphorus and the like due to the gradual loss of kidney function, and calcium, iron and zinc are often deficient; in addition, amino acids, water-soluble vitamins, trace elements and plasma proteins are lost from the dialysate during dialysis, and vitamin deficiency can occur, wherein water-soluble vitamin deficiency is more common; 1,25- (OH) 2-vitamin D3 is often deficient due to renal failure.
Patent CN108651988A discloses a special clinical nutritional formula for renal dialysis and a preparation method thereof, which provides nutritional requirements for proteins, fats, carbohydrates and the like required by renal dialysis patients, but is not designed according to metabolic characteristics of renal dialysis patients, and cannot ideally meet the nutritional requirements of renal dialysis patients, especially the condition of easy occurrence of protein energy malnutrition, and cannot reduce the micro-inflammation state of patients to effectively improve the physique of chronic renal dialysis patients. There is therefore an urgent need for a nutritional formulation for patients with chronic renal dialysis.
Disclosure of Invention
Aiming at the problems that the nutritional preparation in the prior art can not meet the requirements of a renal dialysis patient on nutrition, particularly protein, and can not reduce the micro-inflammation state of the patient, the invention provides a novel nutritional preparation for the renal dialysis patient.
The nutritional preparation comprises protein, lipid, carbohydrate and dietary fiber; wherein the energy supply ratio of the protein, the lipid, the carbohydrate and the dietary fiber is respectively 12-16%, 25-30%, 52-58% and 1-5%;
the lipid comprises saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid, the energy supply ratio of the saturated fatty acid in the lipid is less than 10%, the energy supply ratio of the monounsaturated fatty acid is 8-22%, and the energy supply ratio of the polyunsaturated fatty acid to the saturated fatty acid is more than 2;
the protein comprises L-carnitine and L-glutamine, and the mass ratio of the L-carnitine to the L-glutamine is 1: 1-1.5.
It is to be noted that the carbohydrate of the present invention is a kind of carbohydrate other than dietary fiber.
The Chinese and English names are interpreted as follows:
ESRD, end-stage renal disease
PEM, Protein-Energy Malnutrition, Protein Energy Malnutrition
P/S, Polyunsamrated fatty acid, Saturated fatty acid, Polyunsaturated fatty acid/Saturated fatty acid
TG, trigyceride, triglycerides
VLDL, Very low-density Lipoprotein
LDL, Low Density Lipoprotein, Low Density Lipoprotein
HDL, High Density Lipoprotein
IgA, IgG, IgM, immunolobulin a, G, M, Immunoglobulin A, G, M.
The invention provides a special nutritional preparation for kidney disease dialysis patients with low carbohydrate, high polyunsaturated fatty acid/saturated fatty acid, wherein the energy supply ratio of main nutritional components is controlled within the range, physiological characteristics and metabolic requirements of dialysis patients can be met, the dosage of saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid is controlled within the range, wherein the monounsaturated fatty acid can enhance insulin sensitivity, blood low-density lipoprotein and triglyceride levels are reduced, the high-density lipoprotein content is increased, the dietary quantity is increased appropriately, the occurrence of hypercholesterolemia and cardiovascular diseases can be adjusted, the polyunsaturated fatty acid can reduce blood lipid level and kidney injury, the ratio of the polyunsaturated fatty acid to the saturated fatty acid is controlled to be more than 2, namely the dosage of the saturated fatty acid is reduced, the dosage of the saturated fatty acid is beneficial to preventing the increase of blood triacylglycerol and cholesterol levels, the L-carnitine can assist in-transcrythroid mitochondria to carry out β oxidation, after the carnitine dialysis patients are supplemented, most of the blood plasma concentration is increased, after dialysis patients are treated, the supplementation of carnitine deficiency and the alleviation of relevant symptoms of L-cell metabolism, the L-macrophage function of the L-macrophage cell metabolism is improved, the nutritional preparation is taken as an important nutrition, the synergistic and macrophage improvement of L-macrophage, the L-macrophage, and macrophage proliferation of the L-glutamine can be improved, and macrophage, and the symptoms of the kidney diseases can be improved after the symptoms of the patients.
Preferably, the lipid comprises high oleic sunflower oil, safflower oil and linseed oil; the content of oleic acid in the high-oleic acid sunflower seed oil is 80-85%.
Further preferably, the mass ratio of the high oleic acid sunflower oil to the safflower oil to the linseed oil is 1: 0.2-0.3: 0.1 to 0.2. The proportion of the oil is controlled in the range, the energy supply proportion of saturated fatty acid is less than 10%, the energy supply proportion of monounsaturated fatty acid is 8-22%, and the proportion of polyunsaturated fatty acid and saturated fatty acid is more than 2.
Preferably, the carbohydrate is two or more of maltodextrin, fructose, tapioca starch and isomaltulose. The fructose and isomaltulose have low Glycemic Index (GI) value, and the increase degree of human blood sugar after eating the fructose is far lower than that of other traditional natural sugar products under the same condition, so the fructose and isomaltulose are very suitable for being applied to the diets of diabetics and patients with liver insufficiency. The cassava starch is a slowly hydrolyzed polysaccharide, wherein the ratio of amylopectin to amylose is 15:85, the digestion and absorption speed of the cassava starch in a human body is slow, and the cassava starch is favorable for reducing postprandial hyperglycemia of a nephropathy patient.
Preferably, the dietary fiber is one or more of inulin, fructo-oligosaccharide, isomaltooligosaccharide and galacto-oligosaccharide. The addition of dietary fibers is beneficial to reducing plasma cholesterol, and can also be beneficial to discharging nitrogen in intestinal tracts by reducing nitrogen formed by bacteria in colon, so that blood urea nitrogen is reduced, and uremia symptoms are relieved.
Preferably, the protein comprises animal protein; the amino acid pattern of the animal protein is closer to that of the human body, and the animal protein can be digested and absorbed by the human body more easily.
Preferably, the animal protein is whey protein isolate, which contains a higher proportion of protein, a lower proportion of lactose and minerals. The intake limit of minerals such as sodium, potassium, calcium, phosphorus and the like for patients with nephropathy is relatively small, and in order to avoid the content exceeding the standard caused by introducing more uncontrollable minerals into proteins, the isolated whey protein with less minerals is selected as a protein source.
Preferably, per 100g of the nutritional formulation comprises: 45-55 g of two or more of maltodextrin, fructose, cassava starch and isomaltulose, and 13-15 g of a mixture of high oleic acid sunflower oil, safflower oil and linseed oil, wherein the mass ratio of the high oleic acid sunflower oil to the safflower oil to the linseed oil is 1: 0.1-0.3: 0.09-0.2; 14-20 g of isolated whey protein, 1-2 g of L-carnitine, 1-2 g of L-glutamine, and 4.5-6 g of one or more of inulin, fructo-oligosaccharide, isomaltooligosaccharide and galacto-oligosaccharide.
Preferably, the high oleic sunflower oil, safflower oil and linseed oil are added in the form of micro-encapsulated powder. Because the product is powdery, and the process adopts a dry mixing process for production, the high oleic acid sunflower seed oil, the safflower seed oil and the linseed oil all adopt oil microcapsule powder produced by a microencapsulation process as a raw material source of the product oil, and the content of active ingredients in each microcapsule powder is 35-65%.
Preferably, the nutritional formulation further comprises minerals, and per 100g of the nutritional formulation comprises: 200mg of sodium 108-;
preferably, said nutritional formulation further comprises vitamins, per 100g of said nutritional formulationThe nutritional preparation comprises: 4.5-6.5 mug vitamin D, 5-8mg vitamin E, 30-40 mug vitamin K and vitamin B10.5-1.0mg, vitamin B20.6-1.0mg, vitamin B60.6-1.0mg vitamin B120.7-1.2 mu g, 4.0-5.0mg nicotinic acid, 150 mu g folic acid 140, 1.5-2.5mg pantothenic acid, 30-40mg vitamin C and 15-25 mu g biotin.
In the process of taking the nutritional preparation, the dosage of L-glutamine is required to be more than 1.5g/d, the dosage of L-carnitine is required to be more than 0.9g/d, and the nutritional status and the immune function of a patient can be obviously improved by the dosage of the two substances.
As a preferred operating protocol, per 100g of the nutritional formulation comprises:
39-41 g of maltodextrin, 4-6 g of fructose, 16-18 g of separated whey protein, 19-21 g of high oleic acid sunflower oil microcapsule powder, 4.5-6.5 g of safflower oil microcapsule powder, 2-3 g of linseed oil microcapsule powder, 2-3 g of inulin, 1.5-2 g of fructo-oligosaccharide, 0.5-1 g of isomalto-oligosaccharide, 1-2 g of L-carnitine, 1-2 g of L-glutamine, 0.15-0.25 g of vitamin complex and 0.5-1 g of composite mineral;
the mass ratio of the L-carnitine to the L-glutamine is 1: 1;
or, every 100g of the nutritional preparation comprises the following components in parts by weight:
25-27 g of maltodextrin, 4-6 g of fructose, 14-16 g of isomaltulose, 16-18 g of separated whey protein, 21-23 g of high-oleic acid sunflower seed microcapsule powder, 3-5 g of safflower seed oil microcapsule powder, 1.5-2.5 g of linseed oil microcapsule powder, 2-2.5 g of isomaltooligosaccharide, 0.9-1.2 g of galactooligosaccharide, 1.6-2.2 g of inulin, 0.9-1.1 g of L-carnitine, 1.4-1.6 g of L-glutamine, 0.2-0.3 g of vitamin and 0.7-0.8 g of mineral;
the mass ratio of the L-carnitine to the L-glutamine is 1: 1.5.
The preparation method of the nutritional preparation provided by the invention is a dry mixing process.
The mass or the mass ratio related to the invention is the unified standard unit in the field, such as g, kg and the like.
The invention has the following beneficial effects:
1) the invention provides a compatible nutritional preparation according to the metabolism characteristics of a long-term kidney dialysis patient, can effectively improve protein energy malnutrition of the patient, reduces sugar metabolism abnormality and ester metabolism abnormality of the dialysis patient, and obviously improves the nutrition condition of the patient.
2) The invention can also effectively improve the micro-inflammation state of the patient and improve the immunity of the patient.
Detailed Description
The following examples are intended to illustrate the invention but are not intended to limit the scope of the invention.
Among the minerals referred to in the examples, sodium: potassium: copper: magnesium: iron: zinc: manganese: calcium: phosphorus: iodine: chlorine: the mass ratio of selenium is 1:2.2:1.4:1.8E-01:3E-02:1.7E-02:2E-03:1.2:8E-01:2E-04:1.4: 1E-04.
The vitamins of the examples include vitamin D, vitamin E, vitamin K, vitamin B1Vitamin B2Vitamin B6Vitamin B12The mass ratio of the nicotinic acid to the folic acid to the pantothenic acid to the vitamin C to the biotin is 1:1175:7:125:148:0.2:850:25:405:6250: 3.
The contents of the effective components in the high oleic acid sunflower seed microcapsule powder, the safflower seed oil microcapsule powder and the linseed oil microcapsule powder in the embodiment are consistent and are about 50 percent.
Example 1
The embodiment relates to a nutritional preparation, wherein each 100g of the nutritional preparation comprises the following components in parts by weight:
40.82g of maltodextrin, 5.00g of fructose, 16.98g of separated whey protein, 20.20g of high oleic acid sunflower seed microcapsule powder, 5.40g of safflower seed oil microcapsule powder, 2.48g of linseed oil microcapsule powder, 2.56g of inulin, 1.7g of fructo-oligosaccharide, 0.86g of isomaltooligosaccharide, 1.5g of L-carnitine, 1.5g of L-glutamine, 0.2g of vitamin and 0.8g of mineral substances.
In this example, the energy supply percentages for protein, lipid, carbohydrate, and dietary fiber are 14%, 28%, 55%, and 2.4%, respectively;
the energizing ratio of saturated fatty acid is 2.3%, the energizing ratio of monounsaturated fatty acid is 18.3%, and the energizing ratio of polyunsaturated fatty acid is 7.4%.
Example 2
The embodiment relates to a nutritional preparation, wherein each 100g of the nutritional preparation comprises the following components in parts by weight:
26.24g of maltodextrin, 5.00g of fructose, 15.00g of isomaltulose, 16.98g of separated whey protein, 22.0g of high-oleic acid sunflower seed microcapsule powder, 4.00g of safflower seed oil microcapsule powder, 2.08g of linseed oil microcapsule powder, 2.22g of isomaltooligosaccharide, 1.05g of galacto-oligosaccharide, 1.93g of inulin, 1.0g of L-carnitine, 1.5g of L-glutamine, 0.25g of vitamin and 0.75g of mineral.
In this example, the energy supply percentages for protein, lipid, carbohydrate and dietary fiber were 15%, 27%, 56% and 2.4%, respectively;
the energizing ratio of saturated fatty acid is 2.0%, the energizing ratio of monounsaturated fatty acid is 19.3%, and the energizing ratio of polyunsaturated fatty acid is 5.7%.
Comparative example 1
Compared with example 1, the difference is that 27.2g of high oleic acid sunflower seed microcapsule powder, 0.68g of safflower seed oil microcapsule powder and 0.2g of linseed oil microcapsule powder.
After the addition, the energizing ratio of saturated fatty acid was 1.03%, the energizing ratio of monounsaturated fatty acid was 11.47%, and the energizing ratio of polyunsaturated fatty acid was 1.18%.
Comparative example 2
The difference from example 1 is that the amount of L-carnitine added is 0.2g and the amount of L-glutamine added is 0.5 g.
Examples of the experiments
The nutritional preparations described in examples 1 to 2 and comparative examples 1 to 2 were administered to patients with chronic renal dialysis.
Experimental methods the patients in the observation group (examples 1-2, comparative examples 1-2) were all administered about 400-600 kcal/day of calories; the control group patients were given a plain dietary instruction with continued intervention for 1 month. In the course of treatment, if serious infection, digestive tract hemorrhage, cardiovascular and cerebrovascular accident and other serious complications occur, the patient should be quitted.
Observation index
⑴ nutrient-related proteins and trace elements
Before and after intervention, 3.0mL of fasting elbow venous blood of two groups of patients is extracted, and the contents of nutrition-related proteins including Total Protein (TP), Albumin (ALB), Prealbumin (PA), hemoglobin (Hb) and Transferrin (TRF) are detected by adopting a radioimmunoassay. Detecting the contents of trace elements including zinc (Zn), iron (Fe) and calcium (Ca) by using a full-automatic biochemical analyzer.
⑵ micro inflammatory state
Before and after intervention, 2.0mL of fasting peripheral blood of two groups of patients is obtained, anticoagulation and low-speed centrifugation are carried out to take upper serum, and the content of inflammatory factors including interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF- α) is determined by adopting an enzyme-linked immunosorbent assay.
All data are analyzed and processed by SPSS21.0 statistical software, the measurement data of nutrition-related protein, trace elements, inflammatory factors and the like are expressed by mean +/-standard deviation, and the difference is more than 0.05 by adopting t test, so that the statistical significance is realized.
The experimental subjects selected 100 patients with blood purification center maintenance hemodialysis complicated malnutrition, wherein 52 men, 48 women, age 20-80, 34 cases of primary onset chronic glomerulonephritis, 32 cases of diabetic nephropathy, 16 cases of hypertensive nephropathy, 14 cases of other secondary nephropathy and 4 cases of unknown cause nephropathy, were randomly divided into a control group and an observation group (examples 1-2 and comparative examples 1-2), and 20 cases of each group were selected according to the criteria of ① regular hemodialysis for more than 6 months, 2-3 times per week, ② did not have serious heart failure, uremia encephalopathy, severe infection and other serious complications, ③ had no bleeding or history in nearly 6 months, ④ had no trauma or surgical history, ⑤ all patients serum Albumin (ALB) was less than 35g/L, ⑥ subjective comprehensive nutrition SGA score is less than 25, ⑦ patient Urea (URR) decreased by more than 65% once.
The hemodialysis method comprises the steps of adopting daily machine DBB-26 or DBB-27, a polysulfone membrane and bicarbonate dialysate, wherein the flow rate is 500ml/min, and the blood flow rate is 200-280 ml/min. The dialysis time is 4h each time, 2-3 times per week, and the arterio-venous internal fistula is used.
Results of the experiment
⑴ nutrient-related proteins
5 groups had no significant difference in TP (total protein), ALB, PA, Hb, TRF content in peripheral blood before intervention (P > 0.05); compared with the pre-intervention group, the contents of TP, ALB, PA, Hb and TRF in the peripheral blood after the intervention of the example group are obviously increased (P is less than 0.05), and the contents of TP, ALB, PA, Hb and TRF in the peripheral blood after the intervention of the control group and the comparative group 1 are not obviously changed (P is more than 0.05); and compared with the control group, the content of TP, ALB, PA, Hb and TRF in peripheral blood after intervention is obviously increased in the example group and the comparative example group 2 (P < 0.05). See table 1.
Table 1 comparison of the content of nutritionally relevant proteins in peripheral blood before and after each treatment (n ═ 20)
Figure BDA0002290180230000091
⑵ trace elements
Before 5 groups of interventions, the contents of Zn, Fe and Ca in peripheral blood have no significant difference (P is less than 0.05); compared with the group before the intervention, the contents of Zn and Fe in the peripheral blood are obviously increased, the content of Ca is obviously reduced (P is less than 0.05) after the intervention of the example group and the comparative example group, and the contents of Zn, Fe and Ca in the peripheral blood are not obviously changed (P is less than 0.05) after the intervention of the control group; compared with a control group, the contents of Zn and Fe in peripheral blood are obviously increased and the content of Ca is obviously reduced after the intervention of an observation group (P is less than 0.05). See table 2.
Table 2 comparison of the content of trace elements in peripheral blood before and after each treatment (n ═ 20)
Figure BDA0002290180230000101
⑶ inflammatory factor
The content of IL-6, hs-CRP and TNF- α in the serum before intervention in each group was not significantly different (P < 0.05), the content of IL-6, hs-CRP and TNF- α in the serum after intervention in the example group was significantly reduced (P < 0.05) compared with the content before intervention in the group, the content of IL-6, hs-CRP and TNF- α in the serum after intervention in the control group and the comparative group was not significantly changed (P > 0.05), and the content of IL-6, hs-CRP and TNF- α in the serum after intervention in the example group was significantly reduced (P < 0.05) compared with the control group, see Table 3.
Table 3 comparison of inflammatory factor content in peripheral blood before and after treatment (n ═ 20)
Figure BDA0002290180230000102
Figure BDA0002290180230000111
The kidney disease dialysis type nutritional preparation can effectively optimize the nutritional state of patients with maintenance hemodialysis combined malnutrition and reduce the micro-inflammation degree.
Although the invention has been described in detail hereinabove by way of general description, specific embodiments and experiments, it will be apparent to those skilled in the art that many modifications and improvements can be made thereto based on the invention. Accordingly, such modifications and improvements are intended to be within the scope of the invention as claimed.

Claims (10)

1. A nutritional formulation suitable for renal dialysis patients, comprising protein, lipid, carbohydrate and dietary fiber; wherein the energy supply ratio of the protein, the lipid, the carbohydrate and the dietary fiber is respectively 12-16%, 25-30%, 52-58% and 1-5%;
the lipid comprises saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid, the energy supply ratio of the saturated fatty acid in the lipid is less than 10%, the energy supply ratio of the monounsaturated fatty acid is 8-22%, and the energy supply ratio of the polyunsaturated fatty acid to the saturated fatty acid is more than 2;
the protein comprises L-carnitine and L-glutamine, and the mass ratio of the L-carnitine to the L-glutamine is 1: 1-1.5.
2. The nutritional formulation according to claim 1, wherein the lipid comprises high oleic sunflower oil, safflower oil and linseed oil; the proportion of oleic acid in the high-oleic acid sunflower seed oil is 80-85%.
3. The nutritional formulation according to claim 2, wherein the mass ratio of the high oleic sunflower oil, safflower oil and linseed oil is 1: 0.1-0.3: 0.1 to 0.2.
4. A nutritional formulation according to any of claims 1 to 3 wherein the carbohydrate is two or more of maltodextrin, fructose, tapioca starch and isomaltulose.
5. A nutritional formulation according to any one of claims 1 to 4, wherein the dietary fibre is one or more of inulin, fructo-oligosaccharide, isomalto-oligosaccharide and galacto-oligosaccharide.
6. A nutritional formulation according to any of claims 1 to 5 wherein said protein further comprises animal protein, preferably whey protein isolate.
7. The nutritional formulation according to any one of claims 1 to 6, comprising per 100g of the nutritional formulation: 45-55 g of two or more of maltodextrin, fructose, cassava starch and isomaltulose, and 13-15 g of a mixture of high oleic acid sunflower oil, safflower oil and linseed oil, wherein the mass ratio of the high oleic acid sunflower oil to the safflower oil to the linseed oil is 1: 0.1-0.3: 0.09-0.2; 14-20 g of isolated whey protein, 1-2 g of L-carnitine, 1-2 g of L-glutamine, and 4.5-6 g of one or more of inulin, fructo-oligosaccharide, isomaltooligosaccharide and galacto-oligosaccharide.
8. The nutritional formulation according to claim 7, wherein the high oleic sunflower oil, safflower oil and linseed oil are added in the form of micro-encapsulated powders.
9. The nutritional formulation according to any one of claims 1 to 8, further comprising a complex mineral, wherein per 100g of the nutritional formulation comprising the complex mineral: 200mg of sodium 108-;
and/or, further comprising a multivitamin, wherein per 100g of the nutritional formulation comprising the multivitamin: 4.5-6.5 mug vitamin D, 5-8mg vitamin E, 30-40 mug vitamin K and vitamin B10.5-1.0mg, vitamin B20.6-1.0mg, vitamin B60.6-1.0mg vitamin B120.7-1.2 mu g, 4.0-5.0mg nicotinic acid, 150 mu g folic acid 140, 1.5-2.5mg pantothenic acid, 30-40mg vitamin C and 15-25 mu g biotin.
10. The nutritional formulation according to claim 1 or 9, comprising per 100g of the nutritional formulation:
39-41 g of maltodextrin, 4-6 g of fructose, 16-18 g of separated whey protein, 19-21 g of high oleic acid sunflower oil microcapsule powder, 4.5-6.5 g of safflower oil microcapsule powder, 2-3 g of linseed oil microcapsule powder, 2-3 g of inulin, 1.5-2 g of fructo-oligosaccharide, 0.5-1 g of isomalto-oligosaccharide, 1-2 g of L-carnitine, 1-2 g of L-glutamine, 0.15-0.25 g of vitamin complex and 0.5-1 g of composite mineral;
the mass ratio of the L-carnitine to the L-glutamine is 1: 1;
or, every 100g of the nutritional preparation comprises the following components in parts by weight:
25-27 g of maltodextrin, 4-6 g of fructose, 14-16 g of isomaltulose, 16-18 g of separated whey protein, 21-23 g of high-oleic acid sunflower seed microcapsule powder, 3-5 g of safflower seed oil microcapsule powder, 1.5-2.5 g of linseed oil microcapsule powder, 2-2.5 g of isomaltooligosaccharide, 0.9-1.2 g of galactooligosaccharide, 1.6-2.2 g of inulin, 0.9-1.1 g of L-carnitine, 1.4-1.6 g of L-glutamine, 0.2-0.3 g of vitamin and 0.7-0.8 g of mineral;
the mass ratio of the L-carnitine to the L-glutamine is 1: 1.5.
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