早期肠外及肠内营养续贯性治疗对神经外科ICU患者免疫功能的影响  

Effect of unremitting treatment with early enteral and parenteral nutrition on immune function of patients in neurosurgical ICU

作　　者：鲍刚[1] 廉海平[1] 郭世文[1] 李涛[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,陕西西安710061

出　　处：《第四军医大学学报》2007年第19期1799-1801,共3页Journal of the Fourth Military Medical University

摘　　要：目的:研究早期进行全胃肠外营养(TPN)及胃肠内营养(EN)续贯性治疗对于神经外科危重患者免疫功能的影响.方法:采用前瞻性对比研究方法,将病例随机分为早期TPN+EN续贯性治疗组和早期TPN组两组,比较营养支持后淋巴细胞中CD3+,CD4+,CD8+比率,CD4+/CD8+比值和血浆中IgA,IgM,IgG浓度.结果:随着治疗时间的延长,早期TPN+EN续贯性治疗组CD3+由(51.5±6.7)%升至(61.4±6.5)%;CD4+由(28.5±6.4)%升至(35.9±7.2)%;CD8+由(19.6±6.8)%升至(21.5±6.5)%;CD4+/CD8+由(1.5±0.5)%升至(1.7±0.5)%.血浆中IgA由(1.91±0.42)g/L升至(2.37±0.31)g/L;IgM由(1.43±0.44)g/L升至(1.85±0.41)g/L;IgG由(11.16±1.89)g/L升至(13.38±2.08)g/L.而上述指标在早期TPN组中升高程度较小,两组间差异有统计学意义(P<0.05).结论:早期肠外及肠内营养续贯性治疗可明显促进患者免疫功能的恢复.AIM： To study the effect of unremitting treatment with early enteral and parenteral nutrition on immune function of critically ill patients in neurosurgerical department. METHODS： A prospective control study was carried out. The patients were randomly divided into 2 groups： early parenteral nutrition group and unremitting treatment group with enteral and parenteral nutrition. The percentage of T lymphocyte subsets （CD3^± , CD4^± , CD8^± ）, the ratio of CD4^± ±/CD8^± and plasma levels of IgA, IgM and IgG were compared before and after treatment. RESULTS： In unremitting treatment group with enteral and parenteral nutrition, the percentage of T lymphocyte subsets CD3^± increased from （51.5±6.7）% to （61.4±6.5）%, CD4^＋ from （28.5± 6.4）% to （35.9 ±7.2）%, CD8^＋ from （19.6±6.8）% to （21.5 ±6.5）%, the ratio of CD4^＋/CD8^＋ from （1.5 ±0.5）% to （ 1.7 ± 0.5 ） % ; and plasma levels of IgA raised from （ 1.91 ±_ 0.42） g/L to （2.37 ± 0.31 ） g/L, IgM from （ 1.43 ± 0.44） g/L to （1.85 ±0.41） g/L, and IgG from （11.16 ± 1.89） g/L to （ 13.38 ± 2.08 ） g/L. The indices were significantly different with that in early parenteral nutrition group （ P 〈 0.05 ）. CONCLUSION： Unremitting treatment with early enteral and parenteral nutrition can promote recovery of patients immune function.

关 键 词：神经外科 胃肠外营养 肠内营养 免疫 

分 类 号：R651.1[医药卫生—外科学]