摘要
目的探讨不同肠内营养方式对改善急性重症脑卒中患者营养、免疫功能的临床效果。方法选取2018年8月—2020年8月本院收治的急性重症脑卒中120例为研究对象,根据营养改善方案不同分为对照组58例及观察组62例,对照组给予肠内营养混悬液,观察组给予肠内营养乳剂。比较2组入院第1、7天C反应蛋白(CRP)、营养指标、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、T淋巴细胞亚群情况,并评估预后。结果与入院第1天比较,2组入院第7天CRP水平明显降低,且观察组低于对照组(P<0.05,P<0.01)。与入院第1天比较,入院第7天对照组IgG、IgA、IgM水平比较差异无统计学意义(P>0.05),但观察组IgG、IgA、IgM水平高于治疗前及对照组(P<0.05,P<0.01)。与入院第1天比较,2组入院第7天CD4+、CD4+/CD8+水平升高,CD8+水平降低,且观察组较对照组变化更显著(P<0.05,P<0.01)。与入院第1天比较,2组入院第7天总蛋白、血红蛋白均下降,前白蛋白升高,且观察组较对照组变化更显著(P<0.05,P<0.01)。观察组入院第7天白蛋白水平低于入院第1天及对照组(P<0.05)。与对照组比较,观察组多器官功能障碍综合征评分、急性生理学及慢性健康状况评分系统Ⅱ评分显著降低,格拉斯哥预后评分显著增高(P<0.01)。结论肠内营养乳剂可改善急性重症脑卒中患者营养状态、提高患者机体免疫功能,为疾病的治疗及康复创造了有利条件。
Objective To explore efficiencies of different methods of enteral nutrition on improving nutrition and immune function of patients with acute severe stroke.Methods A total of 120 patients with acute severe stroke admitted between August 2018 and August 2020 were selected and divided into control group(n=58)and observation group(n=62)according to different methods of nutrition improvement.Control group was given enteral nutritional suspension,while observation group was given enteral nutrition emulsion.Levels of C reactive protein(CRP),nutritional indicators,immunoglobin G(IgG),immunoglobin A(IgA),immunoglobulin M(IgM)and T-lymphocyte subsets on the 1 st and 7 th d after admission were compared,and prognoses were evaluated in two groups.Results Compared with those on the 1 st d after admission,CRP levels were significantly lower on the 7 th d after admission in two groups,and the level in observation group was significantly lower than that in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,no significant differences were found in levels of IgG,IgA and IgM on the 7 th d after admission in control group(P>0.05),but levels of IgG,IgA and IgM in observation group were significantly higher than those before treatment in the same group and in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,levels of CD4+and CD4+/CD8+were significantly increased,while CD8+levels were significantly decreased on the 7 th d after admission in two groups,and the change in observation group were more significant than those in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,TP and Hb levels were significantly decreased,while PA levels were significantly increased on the 7 th d after admission in two groups,and the changes in observation group were more significant than those in control group(P<0.05,P<0.01).Albumin level in observation group on the 7 th d after admission was significantly lower than that on the 1 st d after admission in the same group and that in control group(P<0.05).Compared with those in control group,scores of multiple organ dysfunction syndrome,acute physiology and chronic health evaluation(APACHE II)were significantly lower,while Glasgow prognosis score was significantly higher in observation group(P<0.01).Conclusion Enteral nutrition emulsion may improve nutritional status,improve immune function of body and create favorable conditions for disease treatment and rehabilitation in patients with acute severe stroke.
作者
陈二花
李博
王雄
施雪英
CHEN Er-hua;LI Bo;WANG Xiong;SHI Xue-ying(Department of Clinical Nutrition,Anqing Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China;Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China)
出处
《解放军医药杂志》
CAS
2021年第8期96-100,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省科学技术厅项目(2018SF-015)。
作者简介
陈二花,硕士研究生,主治医师。主要从事肠内肠外营养方面的研究;通讯作者:李博,E-mail:leebo397@163.com。
