肠内营养支持对老年AECOPD并呼吸衰竭患者的心肺功能及营养免疫状况中的影响  

Influence of enteral nutrition support on cardiac and pulmonary function and nutritional immunity status in elderly patients with AECOPD and respiratory failure

作　　者：吕卓江 吴庭安[2] 张道进[1] 范元[1] 甘晓虹[1] 

机构地区：[1]广东省江门市第二人民医院呼吸内科,广东江门529000 [2]广东省江门市中心医院呼吸内科,广东江门529000

出　　处：《中国当代医药》2017年第20期26-29,共4页China Modern Medicine

摘　　要：目的研究肠内营养支持对老年慢性阻塞性肺疾病急性加重期(AECOPD)并呼吸衰竭患者心肺功能及营养免疫的影响。方法随机选择我院2014年10月~2016年10月收治的87例老年AECOPD并呼吸衰竭患者,对其临床资料进行回顾性分析,将行肠内营养的40例患者作为观察组,将行常规饮食的47例患者作为对照组,观察比较两组的心肺功能和营养免疫状况。结果两组的不良反应发生率比较,差异无统计学意义(P>0.05)。观察组治疗后的血清总蛋白、白蛋白、转铁蛋白、血红蛋白水平高于治疗前及对照组治疗后,差异有统计学意义(P<0.05)。观察组治疗后的log NT-pro BNP、Pa CO2水平低于治疗前及对照组治疗后,LVEF、Pa O2、pH水平高于治疗前及对照组治疗后,差异有统计学意义(P<0.05)。两组治疗后的hs-CRP、TNF-α水平低于治疗前,差异有统计学意义(P<0.05)。观察组治疗后的Ig A、Ig G、CD3+、CD4+水平高于治疗前及对照组治疗后,hs-CRP、TNF-α水平低于对照组治疗后,差异有统计学意义(P<0.05)。结论对于老年AECOPD合并呼吸衰竭的患者行肠内营养支持,能够明显增强其心肺功能,改善营养状况,提高免疫功能,值得推广。Objective To study the influence of enteral nutrition support on cardiac and pulmonary function and nutritional immunity status in elderly patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and respiratory failure.Methods The clinical data of 87 elderly patients with AECOPD complicated with respiratory failure treated in our hospital from October 2014 to October 2016 were retrospectively analyzed,a total of 40 patients with enteral nutrition were selected as the observation group,and 47 normal diet patients were selected as the control group.The cardiac and pulmonary function and nutritional immunity of the two groups were observed and compared. Results There was no significant difference in the incidence rate of adverse reactions between the two groups （P〉0.05）. The levels of serum total protein,albumin,transferrin and hemoglobin after treatment in the observation group was higher than that before treatment and in the control group after treatment,with significant difference （P〈0.05）.The levels of logNT-proBNP and PaCO2 after treatment in the observation group was lower than that before treatment and in the control group after treatment,and the levels of LVEF,PaO2 and pH after treatment in the observation group was higher than that before treatment and in the control group after treatment,with significant difference （P〈0.05）.The levels of hs-CRP and TNF-α after treatment in the two groups was lower than that before treatment,with significant difference （P〈0.05）. The levels of IgA,IgG,CD3^＋,CD4^＋ after treatment in the observation group was higher, than： that before treatment and in the control group after treatment,and the levels of hs-CRP and TNF-α after treatment in the observation group was lower than that in the control group after treatment,with significant difference （P〈0.05）.Conclusion For elderly AECOPD patients with respiratory failure patients,enteral nutrition can obviously enhance cardiac and pulmonary function, improve nutrit

关 键 词：肠道营养 慢性阻塞性肺疾病 加重期 心肺功能 营养免疫 

分 类 号：R563.9[医药卫生—呼吸系统]