摘要
目的:探讨微生态制剂联合免疫增强型肠内营养治疗重症肺炎患者的临床疗效及对患者营养状态、肠道菌群、T淋巴细胞亚群水平及炎症反应指标的影响。方法:选取2018年10月~2022年1月邯郸市中心医院收治的126例重症肺炎患者,以随机数字表法分为观察组、对照组各63例。对照组采用免疫增强型肠内营养治疗,观察组在对照组基础上加用微生态制剂治疗。比较两组临床疗效、症状变化情况、治疗前后营养指标[血红蛋白(HGB)、白蛋白(ALB)、前白蛋白(PA)]、肠道菌群(双歧杆菌、乳酸杆菌、肠球菌、大肠埃希菌、弯曲杆菌)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子水平[白介素-6(IL-6)、可溶性血管细胞黏附分子1(sVCAM-1)、C反应蛋白(CRP)]。结果:观察组总有效率(93.65%)高于对照组(80.95%)(P<0.05);观察组体温恢复正常时间、肺部阴影消失时间、咳嗽改善时间、住院时间较对照组短(P<0.05);治疗后观察组HGB、ALB、PA水平较对照组升高(P<0.05);治疗后观察组双歧杆菌较对照组高,乳酸杆菌、肠球菌、大肠埃希菌、弯曲杆菌较对照组降低(P<0.05);治疗后观察组CD8^(+)较对照组降低,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较对照组高高(P<0.05);治疗后观察组血清IL-6、sVCAM-1、CRP水平较对照组降低(P<0.05)。结论:微生态制剂联合免疫增强型肠内营养治疗重症肺炎效果显著,可有效促使症状改善,调节肠道菌群、增强机体免疫功能、改善营养状态、减轻机体炎症反应,值得临床借鉴应用。
Objective:To investigate the clinical efficacy of microecological preparation combined with immune enhanced enteral nutrition in the treatment of patients with severe pneumonia,and its effects on nutritional status,intestinal flora,T lymphocyte subsets and inflammatory response indexes.Methods:A total of 126 patients with severe pneumonia admitted to Handan Central Hospital from October 2018 to January 2022 were randomly divided into observation group and control group,with 63 cases in each group.The control group was treated with immune enhanced enteral nutrition,and the observation group was treated with microecological preparation on the basis of the control group.The clinical efficacy,symptom changes,nutritional indicators[hemoglobin(HGB),albumin(ALB),prealbumin(PA)],intestinal flora(bifidobacterium,lactobacillus,enterococcus,escherichia coli,campylobacter),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factor levels[interleukin-6(IL-6),soluble vascular cell adhesion molecule 1(sVCAM-1),C-reactive protein(CRP)]were compared between the two groups before and after treatment.Results:The total effective rate of the observation group(93.65%)was higher than that of the control group(80.95%)(P<0.05).The body temperature recovery time,lung shadow disappearance time,cough improvement time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).After treatment,the levels of HGB,ALB and PA in the observation group were higher than those in the control group(P<0.05).After treatment,bifidobacterium in the observation group was higher than that in the control group,and lactobacillus,enterococcus,escherichia coli and campylobacter were lower than those in the control group(P<0.05).After treatment,CD8^(+)in the observation group was lower than that in the control group,and CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).After treatment,the levels of serum IL-6,sVCAM-1 and CRP in the observation group were lower than
作者
未培轩
史俊峰
翟丽波
薛现英
宋旭光
王景梅
WEI Pei-xuan;SHI Jun-feng;ZHAI Li-bo;XUE Xian-ying;SONG Xu-guang;WANG Jing-Mei(Department of Intensive Care Unit,Handan Central Hospital,Handan,Hebei,056000,China;Department of Respiratory Medicine,Handan Central Hospital,Handan,Hebei,056000,China)
出处
《现代生物医学进展》
CAS
2023年第22期4334-4338,4389,共6页
Progress in Modern Biomedicine
基金
河北省2021年度医学科学研究课题计划项目(20211832)。
关键词
微生态制剂
免疫增强型肠内营养
重症肺炎
肠道菌群
T淋巴细胞亚群
营养状态
炎症反应
Microecological preparation
Immune enhanced enteral nutrition
Severe pneumonia
Nutritional status
Intestinal flora
T lymphocyte subsets
Inflammatory response
