摘要
目的:分析免疫增强型肠内营养对脓毒性休克合并急性胃肠损伤(acute gastrointestinal injury, AGI)患者免疫功能、炎症介质水平及预后的影响。方法:选取2022年1月-12月期间我院收治的108例脓毒性休克合并AGI患者作为研究对象,采用随机数字表法将其分为观察组(54例)和对照组(54例)。两组患者入院后均在重症医学科(ICU)接受治疗,观察组采用免疫增强型肠内营养制剂治疗,对照组采用标准型肠内营养制剂治疗。采集两组患者治疗前后的免疫功能指标、炎症介质指标、AGI改善情况以及预后情况。结果:治疗1周之后,观察组的T淋巴细胞CD4+百分比和CD4+/CD8+比值均显著高于对照组,均差异有统计学意义(P<0.05);而T淋巴细胞CD8+百分比则明显低于对照组,差异有统计学意义(P<0.05),且观察组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)和IL-8水平明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗后总有效率为77.78%,对照组为55.56%,两组差异有统计学意义(P<0.05)。观察组ICU住院时间、抗感染治疗时间、机械通气时间均少于对照组,差异有统计学意义(P<0.05);但两组患者28 d病死率比较差异无统计学意义(P>0.05)。结论:免疫增强型肠内营养可以改善脓毒性休克合并AGI患者胃肠功能,调节免疫功能、降低体内炎症介质水平。
Objective:To analyze the impact of immune enhanced enteral nutrition on immune function,inflammatory mediator levels,and prognosis in patients with septic shock combined with acute gastrointestinal injury(AGI).Methods:A total of 1o8 patients with septic shock and AGI who were admitted to our hospital from January 2022 to December 2022 were selected as the research objects.Random number table method was used to divide them into observation group and control group,and the number of cases in both groups was 54 cases.Both groups received treatment in the intensive care unit(ICU)after admission.The observation group was treated with immune-enhanced enteral nutrition preparations,and the control group was treated with standard enteral nutrition preparations.The immune function indicators,inflammatory mediator indicators,AGI improvement and prognosis of the two groups of patients before and after treatment were collected.Results:After 1 week of treatment,the CD4+percentage of T lymphocytes and the ratio of CD4^(+)/CD8^(+)in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05),and the CD8^(+)percentage of T lymphocytes in the observation group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-8 were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate after treatment was 77.78%in the observation group and 55.56% in the control group.and the differences between the two groups was statistically significant(P<0.05).In comparison to the control group,the observation group showed significantly shorter durations for ICU hospitalization,anti-infection treatment and mechanical ventilation,the differences were statistically significant(P<0.05).There was no significant difference in mortality rate at 28 days(P>0.05).Conclusion:Immune-enhanced
作者
张迎东
李祥全
ZHANG Yingdong;LI Xiangquan(Department of Intensive Care Unit,Xuzhou Central Hospital,Xuzhou,Jiangsu,221000,China)
出处
《临床急诊杂志》
CAS
2023年第7期364-368,共5页
Journal of Clinical Emergency
关键词
免疫增强型肠内营养
脓毒性休克
急性胃肠损伤
免疫功能
炎症介质
immune-enhanced enteral nutrition
septic shock
acute gastrointestinal injury
immune function
inflammatory mediator
