魔芋甘露低聚糖肠内营养对重型颅脑损伤病人术后免疫功能的作用  

Effects of Enteral Nutrition with Konjak Mannanoligosaccharides on Immune Function in Patients with Severe Traumatic Brain Injury

作　　者：韩芳[1] 程梦婕[1] 李晓迪[1] 刘晔[1] 

机构地区：[1]广州军区武汉总医院营养科,湖北武汉430070

出　　处：《华南国防医学杂志》2015年第12期902-904,927,共4页Military Medical Journal of South China

基　　金：湖北省自然科学基金项目(2015CFB703)

摘　　要：目的探讨魔芋甘露低聚糖(konjak mannanoligosaccharides,KMOS)肠内营养对重型颅脑损伤病人术后免疫功能的改善作用。方法将78例重型颅脑损伤病人随机分为KMOS组和对照组。KMOS组40例病人采用添加了KMOS的肠内营养制剂均营素匀浆膳经鼻胃管管饲;对照组38例病人肠内营养制剂仅采用均营素匀浆膳。比较两组病人术后第1天、第7天和第14天免疫指标及肠内营养相关并发症发生率的差异。结果 KMOS组腹泻发生率显著低于对照组(P<0.05);两组病人术后第1天免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)和免疫球蛋白M(immunoglobulin M,IgM)的水平无统计学差异(P>0.05),总T淋巴细胞(CD3^+)、辅助T淋巴细胞(CD4^+)、细胞毒性T淋巴细胞(CD8^+)水平和CD4^+/CD8^+比值均无统计学差异(P>0.05);术后第7天KMOS组IgM水平和CD4^+水平显著高于对照组(P<0.05);术后第14天KMOS组IgA、IgG和IgM水平显著高于对照组(P<0.05),CD3^+、CD4^+水平和CD4^+/CD8^+比值均显著高于对照组(P<0.05)。结论在肠内营养制剂中添加KMOS可改善重症颅脑损伤病人免疫功能,降低肠内营养相关腹泻的发生率。Objective To study effects of enteral nutrition with konjak mannanoligosaccharides （KMOS） on im- mune function in patients with severe traumatic brain injury.Methods Seventy-eight patients with severe traumatic brain injury were randomly divided into KMOS group （n = 40） and control group （n = 38）.KMOS group received enteral nutri- tion by homogenate diet Junyingsu with konjac mannooligosaccharides and control group were just fed with homogenate diet Junyingsu. The fasting blood sample was collected on the first, seventh and fourteenth day after surgery.Serum immu- noglobulin （IgA, IgG, IgM） and T lymphocyte subsets （CD3 ＋ , CD4＋ , CD8 ＋ , CD4＋/CD8＋ ） were detected. The inci- dence of gastrointestinal complications was observed.Results The incidence of diarrhea in KMOS group was significantly lower than that of control group （P〈0.05）. No significant difference of serum immunoglobulin （IgA, IgG, IgM） and T lymphocyte subsets （CD3＋ , CD4＋ , CD8＋ , CD4＋/CD8＋ ） was found between two groups on the first day after surgery. The serum levels of IgM and CD4 ＋ of KMOS group were significantly increased than those of control group on the sev- enth day after surgery （P〈0.05）.On the fourteenth day after surgery, the serum levels of IgA, IgG, IgM, CD3 ＋ , CD4 ＋ and CD4＋/CD8＋ in KMOS group were all higher than those of control group （P〈0.05）.Conclusion The immune func- tion of patients with severe traumatic brain injury can be improved by enteral nutrition with KMOS and the incidence of enteral nutrition related diarrhea can be decreased.

关 键 词：魔芋甘露低聚糖 重型颅脑损伤 肠内营养 免疫功能 

分 类 号：R333[医药卫生—人体生理学]