摘要
目的探讨肠内营养对脑外伤患者免疫功能及骨质、骨矿含量的影响。方法选取本院2015年5月至2017年5月接诊的脑外伤患者192例为研究对象,根据排除标准除外12例患者,将余符合标准的180例患者采用随机数表法分为试验组和对照组,每组各90例。对照组患者接受常规治疗,试验组患者在对照组治疗基础上给予肠内营养治疗。比较两组患者治疗前后淋巴细胞比值(LY%)、CD4、CD8水平、CD4/CD8比值、人类白细胞抗原DR(human leukocyte antigen DR,HLA-DR)水平、髂骨及L_2、L_3、L_4腰椎的骨密度和骨矿含量。结果治疗后第30天,试验组患者骨密度和骨矿含量均显著高于对照组(P_均<0.05)。治疗后第7天,试验组患者LY%、CD4、HLA-DR水平均显著高于对照组(P_均<0.05),CD8水平显著低于对照组(P <0.05),CD4/CD8比值组间比较无显著差异(P> 0.05)。试验组患者治疗期间泌尿系统感染、肺部感染及腹泻的发生率均显著低于对照组(P_均<0.05)。结论肠内营养能显著提升脑外伤患者机体免疫功能,避免患者骨密度及骨质含量下降,适于在临床推广应用。
Objective To investigate the effect of enteral nutrition on immune function, bone mass and bone mineral content in patients with traumatic brain injury. Method 192 patients with traumatic brain injury in our hospital from May 2015 to May 2017 were selected as the study subjects. According to the exclusion criteria, the remaining 180 patients who met the criteria were divided into experimental group and control group by random number table method, 90 cases in each group. Patients in control group received routine treatment, and patients in experimental group were treated with enteral nntxition on the basis of control group. The levels of lymphocyte ratio （LY%）, CD4, CD8 levels, CD4/CD8 ratio, human leukocyte antigen DR （HLA-DR）, bone mineral density and bone mineral content of iliac bone and L2, L3 and L4 lumbar vertebrae were compared between the two groups before and after treatment. Result 30th days after treatment, the bone mineral density and bone mineral content in experimental group were significantly higher than those in control group （Pall 〈 0.05）. On the 7th day of treatment, the LY%, levels of CD4, HLA-DR in experimental group were significantly higher than those in control group （Pall 〈 0.05）, and the level of CD8 was significantly lower than that in control group （P 〈 0.05）. There was no significant difference in the ratio of CD4/CD8 between two groups （P 〉 0.05）. In the course of treatment, the incidence of urinary tract infection, pulmonary infection and diarrhea in experimental group were significantly lower than that in control group （Pall 〈 0.05）. Conclusion Enteral nutrition can significantly improve the immune function of patients with traumatic brain injury and avoid the decrease of bone mineral density and bone mineral content, it is suitable for clinical application.
作者
钱晓
陈亚文
QIAN Xiao;CHEN Ya-wen(ICU,East Branch of Shanghai Sixth People＇s Hospital,Shanghai 201306,China)
出处
《中国医学前沿杂志（电子版）》
2018年第11期78-81,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
上海市第六人民医院东院院级科学研究基金(院人才2016037)
关键词
肠内营养
脑外伤
免疫功能
骨矿含量
骨密度
Enteral nutrition
Traumatic brain injury
Immune function
Bone mineral content
Bone mineral density
