肠内营养制剂和乳清蛋白对老年人肌肉质量和功能的影响

被引：15

作者：

王秋梅 ^{[1
]}

刘晓红 ^{[1
]}

张片红 ^{[2
]}

顾小红 ^{[3
]}

陈伟 ^{[4
]}

朱鸣雷 ^{[1
]}

吴方 ^{[5
]}

机构：

[1] 北京, 中国医学科学院北京协和医院老年医学科

[2] 杭州, 浙江大学医学院附属第二医院营养科

[3] 重庆, 第三军医大学第三附属医院野战外科研究所老年科

[4] 北京, 中国医学科学院北京协和医院肠内肠外营养科

[5] 上海, 瑞金医院老年医学科

来源：

中华老年医学杂志 | 2016年 / 35卷 / 08期

关键词：

骨骼肌减少症; 营养; 蛋白质;

D O I：

暂无

中图分类号：

R685 [肌肉疾病及损伤];

学科分类号：

100220 [骨科学];

摘要：

目的了解口服补充肠内营养制剂或优质蛋白质3个月对老年人肌肉质量和功能的影响。方法采用多中心、随机、对照研究。纳入年龄≥65岁有握力或步速下降的社区老年人74例, 分为对照组26例、肠内营养制剂组(佳膳400 kcal/d)27例及蛋白质组(乳清蛋白粉20 g/d)21例。随访3个月, 测定3组老年人步速、握力以及肌肉质量变化。结果对照组、肠内营养制剂(佳膳)组及蛋白质组四肢肌肉质量变化分别为-490.0 g (95%CI:-801.9～-245.5, P=0.001)、90.0 g(95%CI: -346.8～442.0, P=0.241)和-290.0 g (95%CI:-746.6～20.1, P=0.007), 肠内营养制剂组与对照组差异有统计学意义(P=0.019);三组的握力较基线变化分别为1.3 kg(95%CI:0.6(3.3)、4.1 kg(95%CI:2.7～6.7)和2.1 kg(95%CI:1.1～6.2), 差异均有统计学意义(均P<0.05);步速较基线变化分别为0.1 m/s(95%CI:0.1～0.2)、0.1 m/s(95%CI:0.1～0.3)和0.2 m/s(95%CI:0.1～0.3), 均有明显改善(均P<0.05);但步速和握力变化在组间比较, 差异无统计学意义(P>0.05)。结论部分经口补充肠内营养制剂有利于维持社区老年人的肌肉质量, 健康生活方式宣教干预可提高肌肉功能, 但在此基础上补充肠内营养制剂或乳清蛋白质对肌肉功能的提高未见更多获益。

引用

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