老年急性缺血性脑卒中患者添加乳清蛋白早期肠内营养的临床研究  

Application Value of Adding Whey Protein in Early Enteral Nutrition for Elderly Patients with Acute Ischemic Stroke

作　　者：黄育英[1] 卢漫芳[1] 谷欣[1] 

机构地区：[1]惠州市第三人民医院营养科,广东惠州516000

出　　处：《中国食物与营养》2015年第9期83-86,共4页Food and Nutrition in China

基　　金：2014年惠州市科技计划项目"自制匀浆液在脑卒中患者肠内营养的应用研究"(项目编号:2014Y131)

摘　　要：目的:探讨老年急性缺血性脑卒中患者添加乳清蛋白早期肠内营养的效果。方法:将120例老年急性缺血性脑卒中患者按数字随机法分为观察组和对照组,每组患者60例。对照组采用常规治疗和肠内营养,观察组采用常规治疗和乳清蛋白强化的早期肠内营养,两组均治疗28d。比较两组营养状况、免疫功能、肺部感染、骨折等并发症发生情况和预后。结果:观察组治疗28d后体重、总蛋白、血红蛋白和白蛋白等营养学指标水平分别为59.45±22.25kg、72.05±7.42g/d L、16.02±2.75g/d L和41.15±3.68g/d L,均高于对照组的45.42±13.95kg、56.73±6.98g/d L、8.24±2.63g/d L和29.34±2.75g/d L,差异有统计学意义(P<0.05)。观察组治疗14d后Ig A、Ig G、Ig M等免疫球蛋白以及CD4+、CD4+/CD8+等T淋巴细胞及其亚群水平上升,对照组治疗21d后免疫球蛋白及其T淋巴细胞和其亚群水平出现升高,且治疗14d、21d以及28d后观察组免疫球蛋白及其T淋巴细胞和其亚群水平均高于对照组(P<0.05)。观察组肺部感染、骨折等并发症的总发生率为3.33%,显著低于对照组的11.67%(2=7.64,P<0.05)。观察组治疗后3个月、6个月和12个月的复发率和死亡率均显著低于对照组,差异有统计学意义(P<0.01)。结论:添加乳清蛋白早期肠内营养可明显改善老年急性缺血性脑卒中患者的营养状况和预后,提高患者的免疫功能水平并减少并发症的发生,值得临床推广应用。[Objective]To investigate the application value of adding whey protein in early enteral nutrition for elderly patients with acute ischemic stroke. [Method] Totally 120 elderly patients with acute ischemic stroke were divided into observation group and control group by Digital Random Method, 60 cases for each group. Control group adopted conventional treatment and regular enteral nutrition while obser- vation group adopted whey protein strengthened early enteral nutrition on the basis of control group. Two groups were treated for 28d. Nutritional status, immune function, pulmonary infection, fractures and other complications and prognosis of the 2 groups were com- pared. [Result] Weight, total protein, albumin and hemoglobin nutrition index level of observation group ＇after 28d treatment were 59.45 ± 22. 25kg, 72. 05 ± 7.42g/dL, 16.02 ± 2. 75g/dL and 41.15 ± 3.68g/dL respectively, which was higher than the 45.42 ± 13.95kg, 56. 73 ± 6.98g/d, 8.24 ± 2. 63g/dL and 29. 34 ± 2. 75g/dL of control group, and the difference was statistically significant （ P 〈 0. 05 ）. Immune globulin IgA, IgG, IgM and T lymphocytes and their subsets CD4^＋ , CD4^＋/CD8 ^＋ levels of control group after treatment for 14d rose while inmlunoglobulin and T lymphocyte and its subsets level of control treatment rose after treatment for 21d. Immunoglobulin and T lymphocyte and its subsets level of observation group was higher than that of the control group （P 〈 0.05 ） after treatment for 14d, 21d and 28d. Total incidence of pulmonary infection, fracture and other complications was 3.33% , which was significantly lower than the 11.67% of control group （X2 =7.64, P 〈0. 05） . After treatment for 3 months, 6 months and 12 months, recurrence rate and mortality rate of ob- servation group were significantly lower than that of the control group, and the difference was statistically significant （P 〈 0.01 ） . [Conclusion] Adding whey protein in early enteral nutrition for elderly patients with acute ischemic stroke wa

关 键 词：老年 急性缺血性脑卒中 乳清蛋白 早期 肠内营养 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R459.3[医药卫生—临床医学]