肠内营养制剂对老年糖尿病患者糖脂代谢的影响  

Effects of enteral nutrition preparations on glucose and lipid metabolism in elderly diabetic patients

作　　者：熊艳华[2] 张勤[1] 蒋婧瑾[1] 曾文平[3] 杨云梅[1] Xiong Yanhua;Zhang Qin;Jiang J ingjin;Zeng Wenping;Yang Yunmei(Department of Geriatrics, the First Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310009, China, Department of Traditional Chinese. Medicine, Zhejiang Hospital Hangzhou 310013, China;Department of Cardiology ,Zhejiang Hospital ,Hangzhou 310013 ,Chin)

机构地区：[1]浙江大学医学院附属第一医院老年病科,310009 [2]浙江医院中医科,310013 [3]浙江医院心内科,310013

出　　处：《中华老年医学杂志》2018年第6期653-657,共5页Chinese Journal of Geriatrics

基　　金：老年科临床营养实施示范基地;国家临床重点专科建设项目(老年病科)

摘　　要：目的研究肠内营养制剂对老年糖尿病患者糖脂代谢的影响。方法采用随机对照前瞻性研究，选取微营养评定法（MNA-SF）评分为0～11分且存在吞咽困难或不能经口进食的老年糖尿病患者80例，随机分为康全力组、瑞代组、瑞能组、能全力组，每组20例，观察四组患者治疗前、治疗后1个月、2个月、3个月糖脂代谢及营养相关指标的变化。结果治疗3个月后，与基线相比：康全力组与瑞代组空腹血糖下降明显（5.70±0.69）mmo/L和（7.90±1.71）mmol/L与（5.72±1.12）mmol/L和（7.63±1.73）mmol/L，均P〈0.05）、糖化血红蛋白显著下降（6.39±1.11）%和（7.92±1.50）%与（6.86±0.97）%和（7.81±1.04）%，均P〈0.05），组间差异无统计学意义（均P〉0.05）；康全力组、瑞代组、瑞能组24 h血糖波动幅度明显缩小（2.20±0.88）mmol/L和（4.43±2.07）mmol/L，（2.94±1.16）mmol/L和（4.22±1.60）mmol/L，（3.21±1.64）mmol/L和（4.36±1.88）mmol/L，均P〈0.05）；四组白蛋白水平均上升（均P〈0.05），但各组间差异无统计学意义（均P〉0.05）。四组高密度脂蛋白胆固醇均升高（均P〈0.05）。结论含缓释淀粉、果糖、膳食纤维、恰当的ω6和ω3比例的营养制剂，能平稳降低血糖，调整血脂，改善营养状态。ObjectiveTo investigate the effects of enteral nutritional emulsions on glucose and lipid metabolism in elderly patients with diabetes. MethodsThis randomized controlled trail recruited 80 elderly diabetic patients whose MNA-SF scores were between 0-11 with dysphagia or inability for oral feeding and who were randomized into a TPF-DM group, a TPF-D group, a TPF-T group, and a TPF group.Glycolipid metabolism indexes and nutritional indexes were measured before intervention and at 1 m, 2 m and 3 m after intervention.ResultsCompared with baseline levels, FBG and HbA1c declined in the TPF-DM group[（5.70±0.69）mmol/L vs.（7.90±1.71）mmol/L and（6.39±1.11）% vs.（7.92±1.50）%, all P〈0.05]and the TPF-D group[（5.72±1.12）mmol/L vs.（7.63±1.73）mmol/L and（6.86±0.97）% vs.（7.81±1.04）%, all P〈0.05]after 3 months of treatment, but no significant difference was found between these two groups.The TPF-DM, TPF-D, TPF-T groups showed significantly narrower fluctuation ranges of 24 h blood glucose levels after 3 months[（2.20±0.88）mmol/L vs.（4.43±2.07）mmol/L, （2.94±1.16）mmol/L vs.（4.22±1.60）mmol/L, （3.21±1.64）mmol/L vs.（4.36±1.88）mmol/L, all P〈0.05）. Serum albumin levels increased in all four groups, compared with baseline levels（all P〈0.05）, but there was no significant difference between the groups（all P〉0.05）. Furthermore, the serum HDLC level increased in all four groups than baseline （all P〈0.05）.ConclusionsEnteral nutritional emulsions containing slow release starch and fructose, dietary fibers and proper ω6 and ω3 ratio can stabilize blood sugar, regulate blood lipids, and improve nutritional status.

关 键 词：糖尿病 营养不良 碳水化合物代谢 脂类代谢 肠内营养制剂 

分 类 号：R587.1[医药卫生—内分泌]