慢性阻塞性肺病急性加重合并呼吸衰竭病人早期肠内营养联合胸腺肽a1的疗效观察  

Effect of early enteral nutrition combined with thymosin alpha-1 on patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure

作　　者：陈思伟 肖小荣 罗金明 

机构地区：[1]浙江省台州市中心医院ICU,浙江台州318020

出　　处：《肠外与肠内营养》2017年第6期332-335,共4页Parenteral & Enteral Nutrition

摘　　要：目的 :探讨早期肠内营养(EN)联合胸腺肽a1对AECOPD合并呼吸衰竭的疗效。方法 :135例AECOPD病人随机分为试验A组(EN)45例,试验B组(EN+胸腺肽a1)45例,和对照组45例,对照组予常规临床治疗,试验A组在此基础上予瑞能早期肠内营养鼻饲,试验B组在此基础上予瑞能早期肠内营养鼻饲联合皮下胸腺肽a1针,观察三组机械通气时间,检测炎症指标、营养指标以及T细胞亚群。结果 :治疗一周后,试验A组的炎症指标明显低于对照组(P<0.05)、营养指标以及T细胞亚群明显高于对照组(P<0.05)、机械通气时间较对照组明显缩短(P<0.05);而与试验A组相比,试验B组的炎症指标明显降低(P<0.05)、营养指标以及T细胞亚群明显升高(P<0.05)、机械通气时间明显缩短(P<0.05)。结论 :早期肠内营养治疗不仅能缩短AECOPD合并呼吸衰竭病人机械通气时间,而且能改善病人营养状况,降低其炎症指标,增强其免疫功能,进而提高临床疗效,而早期肠内营养联合胸腺肽a1治疗能进一步改善AECOPD合并呼吸衰竭病人的临床疗效。Objective： To explore the effect of early enteral nutrition combined with thymosin alpha-1（T-a1） on patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure. Methods： One hundred and thirty five patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into experimental A group （ EN ） （ n = 45 ）, experimental B group （ EN＋T-al ） （ n = 45 ） and control group （ n = 45 ） . In earlier period, experimental A group received Ruineng enteral nutrition, experimental B group received Ruineng enteral nutrition combined with intramuscular T-al, whereas control group received general clinical therapy. The mechanical ventilation time, inflammatory index, nutritional index and T cell subset index were compared among three groups. Results： Compared to control group, nutritional index and T cell subset index in experimental A group were significantly higher while inflammatory index were lower （ P 〈 0.05 ） , and mechanical ventilation time was shorter （ P 〈 0.05 ） after a week. Compared to experimental group A, nutritional and T cell subset index were significantly higher, inflammatory index were lower, and mechanical ventilation time was shorter （ P 〈 0.05 ） in experimental B group （ P 〈 0.05 ） after a week. Conclusion： Early enteral nutrition can shorten mechanical ventilation time, improve nutritional status, reduce inflammatory indicators, enhance immune function, and thereby improving clinical eff-cacy in patients with AECOPD combined with respiratory failure. Furthermore, early enteral nutrition combined with thymosinal treatment can improve clinical efficacy of AECOPD patients with respiratory failure.

关 键 词：慢性阻塞性肺病 呼吸衰竭 肠内营养 胸腺肽A1 

分 类 号：R459.3[医药卫生—治疗学] R563[医药卫生—临床医学]