肠内免疫营养制剂对高血压脑出血术后患者体液免疫功能的影响  

The effects of enteral immunonutrition on humoral immunity in postoperative patients with hypertensive intracerebral hemorrhage

作　　者：许信龙 魏晓捷 许睿 汤崇辉 方战舰 胡益岚 单钰栋 童云 陈梦丹 XU Xinlong;WEI Xiaojie;TANG Chonghui(Affiliated Cixi Hospital,Wenzhou Medical University,Zhejiang 315300,China)

机构地区：[1]温州医科大学附属慈溪医院,315300

出　　处：《浙江创伤外科》2020年第3期399-402,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省医药卫生科技计划项目(2018KY739)。

摘　　要：目的探讨肠内免疫营养制剂对高血压脑出血患者术后体液免疫功能的影响。方法采用随机数字法将2017年9月至2019年8月入住本院符合研究条件的105例高血压脑出血患者分为两组:常规肠内营养组(对照组,52例)和肠内免疫营养组(免疫组,53例)。对照组给予常规肠内营养制剂瑞代,免疫组给予富含ω-3多不饱和脂肪酸的肠内免疫营养制剂瑞能。在第1天、第7天和第14天分别检测患者的白蛋白、前白蛋白、免疫球蛋白(IgG、IgA和IgM)水平,测定血浆降钙素原的变化,GCS评分和感染的发生率。结果给予肠内营养支持后,两组患者的血清白蛋白和前白蛋白都有升高,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05);对照组患者免疫球蛋白的含量和降钙素含量变化无统计学意义(P>0.05),GCS评分有升高,差异有统计学意义(P<0.05),免疫组患者免疫球蛋白的含量都有增加,降钙素原降低,GCS评分升高,差异有统计学意义(P<0.05),两组间比较,免疫组患者免疫球蛋白的含量升高,降钙素原表达降低,GCS评分升高,差异有统计学意义(P<0.05);免疫组肺部感染的发生率低于对照组,差异有统计学意义(P<0.05)。结论肠内营养能够改善高血压脑出血术后患者营养状况,肠内免疫营养制剂更能促进患者免疫功能的恢复,减少患者术后感染的发生率,改善预后。Objective To explore the effects of enteral immunonutrition on humoral immunity in postoperative patients with hypertensive intracerebral hemorrhage.Methods 105 postoperative patients with hypertensive intracerebral hemorrhage admitted into our hospital from September 2017 to August 2019 were divided into two groups by random number method:routine enteral nutrition group(control group,52 cases)and enteral immunonutrition group(immune group,53 cases).The patients in control group were given Rui-dai,a common enteral nutrition preparation,while the patients in immune group were given Rui-neng,an enteral nutrition preparation rich withω-3 polyunsaturated fatty acids.The level of albumin,prealbumin,and immunoglobulin(IgG,IgA,and IgM)levels were measured on the 1st day,the 7th day and the 14th day,and changes in procalcitonin,GCS score,and incidence of infection were measured.Results After enteral nutrition supports were given,both the albumin and proalbumin in two groups were increased significantly(P<0.05),while there was no significant difference between two groups(P>0.05).There were no statistically significant changes in immunoglobulin content and procalcitonin content in the control group(P>0.05),the scores of GCS were increased significantly(P<0.05).In the immune group,the contents of immunoglobulin were increased,procalcitonin were decreased,and scores of GCS were increased significantly(P<0.05).Comparison between the two groups showed that the contents of immunoglobulin were increased,the contents of procalcitonin were decreased,and the scores of GCS were increased in the immune group significantly(P<0.05).The incidence rate of pulmonary infection in the immune group was lower than that in the control group significantly(P<0.05).Conclusion The enteral nutrition can improve the nutritional status of postoperative patients with hypertensive intracerebral hemorrhage,and enteral immunonutrition can promote the recovery of immune function,reduce the incidence of postoperative infection,and improve the prognosis.

关 键 词：高血压脑出血 手术 肠道屏障 肠内营养 免疫 

分 类 号：R651.1[医药卫生—外科学]