摘要
目的 探讨早期免疫性肠内营养对颅脑损伤患者机体炎性反应和免疫功能的影响。方法 自2015年1月~2016年10月纳入笔者医院所收治的颅脑损伤患者92例,将其随机对照的方法分为研究组(46例)和对照组(46例)。对照组给予常规肠内营养支持治疗,研究组在此基础上联合谷氨酰胺、鱼油及精氨酸。比较两组患者一般临床资料及营养指标、炎性指标、免疫指标和临床预后的差异。结果 两组患者入院时一般临床资料比较,差异无统计学意义(P均>0.05)。两组患者在第1天和第7天血清营养指标,炎性因子浓度和免疫功能指标差异均无统计学意义(P>0.05)。至第14天,研究组血清白蛋白(t=2.578,P=0.012)显著高于对照组;血清CRP浓度(t=4.431,P=0.000)和血清PCT浓度(t=3.486,P=0.001)显著性低于对照组;血清IgA浓度(t=2.801,P=0.006)及IgG浓度(t=3.386,P=0.001)显著性高于对照组。研究组Glassgow评分(t=2.655,P=0.009),APACHEⅡ评分(t=1.983,P=0.049),SOFA评分(t=2.847,P=0.005)较前均明显改善,ICU天数显著性低于对照组(t=3.366,P=0.001);但两组30天病死率差异无统计学意义(χ~2=0.555,P=0.456)。结论 免疫型肠内营养可以更有效地降低机体炎性因子水平,提高机体免疫功能,从而改善患者预后。
Objective To investigate the protective effect of nutrition management therapy on intestinal barrier function and immune function in intra-abdominal infected（IAI） patients. Methods From Jan. 2015 to Oct. 2016,a total of 92 craniocerebral injured patients admitted to our hospital were randomly divided into a study group（46 cases） and a control group（46 cases）. General enteral nutrition support was given in the control group and immune enteral nutrition support including fish oil,glutamine and arginine was implemented in the study group. Clinical characteristics and the level of serum nutritive indexes,inflammation cytokines,immune function index and clinical outcomes were compared between these two groups. Results No significant differences were found in the demographic characteristics between these two groups（all P 〉0.05）. No significant differences were found in serum nutritional index,inflammation cytokines and immune function index at the 1 stand 7 thday between these two groups（all P〉 0.05）. However,the study group showed significantly higher serum level of serum albumin（t = 4. 431,P = 0.000）; significantly lower serum level of CRP（t = 4. 431,P = 0.000） and PCT（t = 3. 486,P = 0.001）; significantly higher serum level of Ig A（t = 2. 801,P = 0.006） and IgG（t = 3. 386,P = 0.001） than the control group. Glasgow score（t = 2. 655,P = 0.009）,APACHE Ⅱ score（t = 1. 983,P = 0.049） and SOFA score（t = 2. 847,P =0.005） improved significantly than the control group. Meanwhile,the study group showed obviously shorter length of ICU stays（10.13 ±3. 82 days vs 13. 56 ± 4. 73 days,t = 3. 366,P = 0.001）. However,statistical differences were not found in 30 days mortality（9/37 vs12/34,χ^2= 0.555,P = 0.456） between these two groups. Conclusion Immune enteral nutrition can effectively improve craniocerebral injured patients＇ nutritional status,decrease the level of serum inflammation cytokines,and protect immune function to ameliorate their clinical outcomes.
作者
杨静
牛瑞芳
窦长武
王飞
苏优勒
Yang Jing;Nin Ruifang;Dou Changwu(The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010050,China)
出处
《医学研究杂志》
2018年第4期61-64,共4页
Journal of Medical Research
基金
内蒙古自治区教育厅基金资助项目(NJ10147)
关键词
颅脑损伤
免疫型肠内营养
炎性反应
免疫功能
Craniocerebralinjur
Immune enteral nutrition
Inflammation response
Immune function
