含缓释淀粉的肠内营养对老年糖脂代谢和肝肾功能的影响  

The effect of enteral nutrition containing slow-release starch on glucose and lipid metabolism,hepatic and renal function in aged patients

作　　者：李健[1] 谢南姿[1] 沈艺[1] 罗帮镇[1] 王海峰[1] 

机构地区：[1]同济大学附属同济医院老年科,上海200065

出　　处：《肠外与肠内营养》2011年第3期132-135,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨含缓释淀粉的肠内营养(EN)制剂,对老年病人糖脂代谢、肝肾功能和营养状况的影响,寻找老年病人合理使用EN的效果评估方法和有效的临床检测指标。方法:将136例老年病人根据进食情况分为三组,以正常进食者作为对照(正常饮食组);因疾病导致进食量减少的病人,给予口服瑞代补充营养(加用EN组);因疾病不能进食者,给予瑞代经鼻饲提供EN(单用EN组)。所有病人提供的总热量约126.5 kJ(30 kcal)/(kg·d)。EN治疗2周后,检测病人空腹和餐后2 h血糖、糖化血红蛋白,脂代谢指标,肝肾功能,超敏C反应蛋白和尿蛋白系列等。结果:与正常饮食组病人比,单用EN组餐后2 h血糖明显降低(P<0.05),糖化血红蛋白趋于正常。与正常饮食组病人比,应用EN的两组病人血清清蛋白水平均降低,球蛋白和超敏C反应蛋白水平均增高,而前清蛋白水平无显著性差异。三组病人血肌酐、尿素氮和尿微量清蛋白、视黄醇结合蛋白、转铁蛋白、β2微球蛋白水平等均无显著性差异。结论:餐后血糖、糖化血红蛋白、血浆前清蛋白等,均是评估老年病人使用EN效果较好的临床指标。含缓释淀粉的EN制剂,可使老年病人的糖脂代谢和肝肾功能得到不同程度地改善。Objective： To investigate the effect of the enteral nutrition containing slow-release starch（Fresubin Diabetes） on glucose and lipid metabolism,hepatic and renal function and nutritional status in aged patients.Methods： 136 aged patients were divided into 3 groups according to the feeding ways： the control group（normal oral diet）,the study group 1（additionally given Fresubin Diabetes orally）,and the study group 2（fed with Fresubin Diabetes through the nasogastric tube）.Total calories were around 30 kcal/（kg·d）.Variables including fasting blood glucose,postprandial blood glucose,glycated hemoglobin,serum lipids,hepatic and renal function,high-sensitivity C-reactive protein（hs-CRP） and urinary protein series were measured two weeks after nutritional support. Results： Compared with the control group,the study group 2 had a significant lower 2-hour postprandial blood glucose（P=0.047） and the level of glycated hemoglobin was more close to normal range.The level of serum albumin in two study groups was lower,and the levels of serum globulin and hs-CRP were higher than in the control group.Conclusions： Aged patients may benefit from the enteral nutrition containing slow-release starch in glucose and lipid metabolism,hepatic and renal function.It is recommended that the aged patients with reduced normal oral diet due to the illness be supported by the enteral nutrition as Fresubin Diabetes.

关 键 词：缓释淀粉 肠内营养 糖脂代谢 肝肾功能 老年病人 

分 类 号：R459.3[医药卫生—治疗学]