乳清蛋白联合肠内营养制剂对糖尿病合并肺结核患者营养支持的疗效观察  

Effect of enteral nutrition with whey protein in diabetic patients with pulmonary tuberculosis

作　　者：侯双雁[1] 叶婷[1] 黄美金[2] 罗雪清[3] 林承雄[1] HOU Shuangyan;YE Ting;HUANG Meijin;LUO Xueqing;LIN Chengxiong(Department of Nutrition,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Infectious Diseases,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Ultrasound,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院营养科,广西百色533000 [2]右江民族医学院附属医院感染性疾病科,广西百色533000 [3]右江民族医学院附属医院超声科,广西百色533000

出　　处：《右江医学》2020年第3期209-212,共4页Chinese Youjiang Medical Journal

基　　金：百色市科学研究与技术开发计划项目(百科20183329)。

摘　　要：目的观察乳清蛋白联合肠内营养制剂对糖尿病合并肺结核患者营养支持的疗效。方法选择60例糖尿病合并肺结核患者进行营养风险筛查(NRS2002)评估,随机分为观察组(30例)、对照组(30例),两组患者均在营养支持前及营养支持4周后观察体重指数(BMI)、血红蛋白(HGB)、血清白蛋白(ALB)、前白蛋白(PA)、视黄醇结合蛋白(RBP)、超氧化物歧化酶(SOD)的结果,再次进行NRS2002评分、结核中毒症状改善时间和痰液转阴的例数。结果观察组治疗后ALB、PA、RBP、SOD与治疗前相比差异有统计学意义(P<0.01),观察组治疗后IBW%、ALB、RBP、SOD较对照组治疗后有明显改善(P<0.05或0.01)。治疗后,NRS2002评估结果显示,两组营养风险均有下降,观察组患者营养状况改善例数明显优于对照组(P<0.05)。观察组结核中毒症状改善时间明显少于对照组(P<0.01),痰液转阴例数显著多于对照组(P<0.05)。结论乳清蛋白联合肠内营养制剂能改善糖尿病合并肺结核患者的营养状态,效果优于单纯使用糖尿病饮食。Objective To observe the effect of enteral nutrition with whey protein in diabetic patients with pulmonary tuberculosis.Methods Sixty patients with diabetes mellitus combined with pulmonary tuberculosis were assessed by nutrition risk screening(NRS2002)and randomized into the observation group and control group(30 cases each).Before and after 4 weeks of nutritional support,both groups were compared in Body Mass Index(BMI),hemoglobin(HGB),serum albumin(ALB),prealbumin(PA),retinol binding protein(RBP)and superoxide dismutase(SOD)results and assessed in NRS2002 score,the improvement time of tuberculosis symptoms and the number of sputum turning negative.Results ALB,PA,RBP and SOD were significantly different from the observation group before and after treatment(P<0.01).After treatment,apparent improvement was observed in IBW,ALB,RBP and SOD between groups(P<0.01);the results of NRS2002 evaluation showed that the nutritional risk of both groups decreased,and the nutritional status of the observation group was significantly better than that of the control group(P<0.05).The improvement time of tuberculosis symptoms in the observation group was significantly lower than that in the control group(P<0.01).The number of cases of sputum conversion in the observation group was significantly more than that in the control group(P<0.05).Conclusion Whey protein combined with enteral nutrition can improve the nutritional status of patients with diabetes mellitus combined with tuberculosis,and the effect is better than diabetes diet.

关 键 词：糖尿病 肺结核 乳清蛋白 肠内营养制剂 营养支持 

分 类 号：R587.2[医药卫生—内分泌]