肠内营养对老年慢性心衰患者营养状态及胰岛素样生长因子1、C反应蛋白及白介素6的影响  

Effect of enteral nutrition on nutritional status and Insulin-like growth factor 1,C reactive protein,and interleukin 6 in elderly patients with chronic heart failure

作　　者：李伟[1] 王义围[1] 王淼[1] 王国玉[1] 王璐[1] 赵翠[1] 冯玉梅[1] LI Wei;WANG Yiwei;WANG Miao;WANG Guoyu;WANG Lu;ZHAO Cui;FENG Yumei(Geriatrics Department of The Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院老年病科,河北承德067000

出　　处：《实用医学杂志》2019年第5期751-755,共5页The Journal of Practical Medicine

基　　金：承德市科学技术研究与发展计划项目(编号:201701A039)

摘　　要：目的探讨肠内营养对老年慢性心衰(CHF)患者营养状态及IGF-1、C反应蛋白及白介素6的影响。方法将老年CHF患者134例,随机单盲取法分为研究组与对照组,每组67例,研究组在常规纠正心力衰竭治疗基础上给予肠内营养支持治疗,对照组在常规纠正心力衰竭治疗基础上给予自愿饮食,观察两组治疗前后营养状态、炎性指标、血清中胰岛素样生长因子-1(IGF-1)、心功能指标、治疗期间不良事件及并发症发生情况。结果研究组治疗后营养状况评分低于同组治疗前及对照组同期(P <0.05),治疗后体质量指数(BMI)、血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、三头肌皮褶厚度(TSF)、上臀肌围(AMC)均高于同组治疗前及对照组同期(P <0.05);总IGF-1、白细胞介素-6(IL-6)、C反应蛋白(CRP)均低于同组治疗前及对照组同期(P <0.05),研究组治疗后心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)及6 min步行距离均高于对照组同期(P <0.05),左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均低于对照组同期(P <0.05)。治疗期间两组均未见不良事件发生,研究组并发症发生率低于对照组(P <0.05)。结论肠内营养支持可改善老年慢性心衰患者营养状态,提高心功能,降低IGF-1、CRP、IL-6水平,达到提高治疗效果目的。Objective To investigate the influence of enteral nutrition on nutritional status,insulin.like growth factor 1(IGF-1),C reactive protein and interleukin 6 in elderly patients with chronic heart failure(CHF). Methods One hundred and thirty.four elderly patients with CHF were divided randomly into study group(n = 67) and control group(n = 67). In addition to routine treatment of CHF,the study group received enteral nutrition support treatment,and the control group reveived voluntary diet. Nutritional status,inflammatory index,the level of serum IGF-1,the incidence of adverse events and complications,and the heart function index were tested before and after treatment. Results The nutritional status of the study group after treatment were lower than those of the same group before treatment and control group after treatment(P<0.05),body mass index(BMI),serum total protein(TP),albumin(ALB),prealbumin(PA),triceps skinfold thickness(TSF),(AMC)were high around the gluteal muscle in the same group before treatment and control group(P<0.05);total IGF.1and interleukin.6 (IL-6),C reactive protein(CRP)were lower than the same group before treatment and the control group(P<0.05), the study group after treatment of ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO) and 6 min walking distance were higher than those in the control group during the same period(P<0.05),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)were lower than the control group(P<0.05). No adverse events occurred in the two groups during the treatment period,and the inci. dence of complications in the study group was lower than that in the control group(P<0.05). Conclusion Enter. al nutrition can improve the nutritional status of elderly patients with chronic heart failure,improve heart function, reduce IGF-1,CRP,IL-6 level,to improve the therapeutic effect.

关 键 词：肠内营养 老年 慢性心衰 营养状态 胰岛素样生长因子1 C反应蛋白 白介素6 

分 类 号：R541.6[医药卫生—心血管疾病]