含缓释淀粉的肠内营养剂对老年人糖脂代谢、肝肾功能的影响  

The effect of slow-release starch containing enteral nutrition 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]上海市同济医院老年科,200065

出　　处：《中华损伤与修复杂志（电子版）》2011年第3期27-30,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨含缓释淀粉的肠内营养剂,对老年人糖、脂代谢,肝肾功能的影响,为肠内营养在老年患者中的合理使用及效果评估寻找有效的临床检测指标。方法 136例老年科收治的患者根据进食情况分为三组,以正常饮食者作为对照(正常饮食组),因疾病导致进食减少者予口服肠内营养剂补充营养(加用肠内营养剂组),因疾病不能进食者,予肠内营养剂经鼻饲提供肠内营养(单用肠内营养剂组)。所有受试者每日提供的总能量约30Kcal/kg。肠内营养十四天后留取血尿标本,检测其空腹及餐后血糖、糖化血红蛋白,脂代谢指标,肝肾功能,高敏C反应蛋白及尿蛋白系列。采用SPSS17.0统计软件进行统计检验。结果与正常饮食组比,单用肠内营养剂组的老年人餐后2h血糖明显降低(P=0.047),糖化血红蛋白更趋于正常。与正常饮食组相比,应用肠内营养剂的两组老人血浆白蛋白水平均降低,球蛋白水平及高敏C反应蛋白水平均增高,差异有统计学意义(P<0.05),而血浆前白蛋白水平无统计学差异(P>0.05)。血肌酐、尿素氮,尿微量白蛋白、尿视黄醛结合蛋白、尿转铁蛋白、尿β2微球蛋白水平在三组中未发现统计学差异。结论含缓释淀粉的肠内营养剂,可使老年人的糖脂代谢、肝肾功能不同程度获益。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 A total of 136 aged patients were divided into 3 groups according to the feeding ways： the control group （patients were able to have normal oral diet）, the study group 1（patients who could not have adequate oral diet were additionally given Fresubin Diabetes by oral）, the study group 2（patients who could not intake by oral were fed with Fresubin Diabetes through the nasal tube）. Total calories were around 30 kcal/kg. 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. Statistical analysis was performed by SPSS 17.0. Results Compared with the control group, the study group 2 have 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 both two study groups was lower, and the levels of serum globulin and hs-CRP were higher than in the control group, while there were no significant differences in the levels of serum prealbumin（P=0.089,P=0.347）. There were no significant differences in the levels of serum creatinine, blood urea nitrogen, microalbuminuria, urinary retinol binding protein, urinary transferrin, urinary beta-2 microglobulin in the three groups. 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 餐后血糖 前白蛋白 老年 

分 类 号：R459.3[医药卫生—治疗学]