谷氨酰胺联合序贯肠内营养治疗对重症脑梗死病人营养状态与预后的影响  

Effects of glutamine combined with sequential enteral nutrition on nutritional status and prognosis of patients with severe cerebral infarction

作　　者：李笑蕾[1] 韩琳[1] LI Xiaolei;HAN Lin(Department of Neurology,Sino-Japanese Friendship Hospital,Jilin University,Changchun,Jilin 130033,China)

机构地区：[1]吉林大学中日联谊医院神经内科,吉林长春130033

出　　处：《安徽医药》2020年第9期1871-1875,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究谷氨酰胺联合序贯肠内营养治疗对重症脑梗死病人营养状态与预后的影响。方法选取2016年3月至2018年4月吉林大学中日联谊医院收治的重症脑梗死病人94例,采用随机数字表法将其分为观察组与对照组,对照组采用序贯肠内营养治疗,观察组采用谷氨酰胺联合序贯肠内营养治疗,对比两组病人营养状态、免疫功能及预后情况。结果入院第1天,两组病人肱三头肌皮褶厚度(TSF)、上臂三头肌肌围(MAMC)、血清前白蛋白(PAB)、血清白蛋白(ALB)及血红蛋白(Hb)指标相比差异无统计学意义(P>0.05),入院第15天,两组病人各营养指标均有所下降,但观察组下降幅度较小,且观察组TSF、MAMC、PAB、ALB及Hb指标均明显高于对照组[(14.02±3.88)mm比(12.12±3.46)mm(t=2.506,P=0.014)、(24.33±3.38)cm比(21.82±2.41)cm(t=4.145,P<0.001)、(188.26±16.17)mg/L比(147.65±14.39)mg/L(t=12.862,P<0.001)、(36.20±3.75)g/L比(34.12±3.26)g/L(t=2.870,P=0.005)、(127.84±18.46)g/L比(118.05±19.21)g/L(t=2.514,P=0.014)];入院第1天,两组病人免疫球蛋白G(IgG)、免疫球蛋白A(IgA)及免疫球蛋白M(IgM)水平相比差异无统计学意义(P>0.05),入院第15天,观察组IgG、IgA及IgM水平均显著高于对照组[(15.32±2.71)g/L比(12.08±2.16)g/L(t=6.410,P<0.001)、(2.65±0.48)g/L比(1.93±0.55)g/L(t=6.762,P<0.001)、(1.26±0.27)g/L比g/L(1.05±0.33)(t=3.377,P=0.001)];入院第15天,观察组神经功能缺损分级量表(NIHSS)评分(8.12±2.43)分显著低于对照组(10.59±2.26)分(t=5.103,P<0.001);观察组总感染率显著低于对照组(P<0.05)。结论谷氨酰胺联合序贯肠内营养治疗可有效改善重症脑梗死病人营养状态,提高免疫功能,降低感染率,改善近期预后。Objective To explore the effect of glutamine combined with sequential enteral nutrition therapy on nutritional status and prognosis of patients with severe cerebral infarction.Methods 94 patients with severe cerebral infarction admitted to China⁃Ja⁃pan Friendship Hospital of Jilin University from March 2016 to April 2018 were selected,they were divided into observation group and control group by random number table,the control group was treated with sequential enteral nutrition,while the observation group was treated with glutamine combined with sequential enteral nutrition,the nutritional status,immune function and prognosis of the two groups were compared.Results On the first day of admission,there were no significant differences in triceps skinfold(TSF),mid⁃arm muscle circumference(MAMC),serum prealbumin(PAB),serum albumin(ALB)and hemoglobin(Hb)between the two groups(P>0.05),on the 15th day of admission,the nutritional indicators of both groups decreased,but the decrease of the observation group was small,and the TSF,MAMC,PAB,ALB and Hb indicators of the observation group were significantly higher than those of the control group,(14.02±3.88)mm vs.(12.12±3.46)mm(t=2.506,P=0.014),(24.33±3.38)cm vs.(21.82±2.41)cm(t=4.145,P<0.001),(188.26±16.17)mg/L vs.(147.65±14.39)mg/L(t=12.862,P<0.001),(36.20±3.75)g/L vs.(34.12±3.26)g/L(t=2.870,P=0.005),(127.84±18.46)g/L vs.(118.05±19.21)g/L(t=2.514,P=0.014);on the 1st day of admission,there was no significant difference in the levels of immunoglobulin G(IgG),immunoglobulin A(IgA)and immunoglobulin M(IgM)between the two groups(P>0.05),on the 15th day of admission,the levels of IgG,IgA and IgM in the observation group were significantly higher than those in the control group(P<0.05);on the 15th day of admission,the National Institute of Health stroke scale(NIHSS)score of the observation group(8.12±2.43)scores was significantly lower than that of the control group(10.59±2.26)scores(t=5.103,P<0.001);the total infection rate in the observation group was significan

关 键 词：脑梗死 肠道营养 谷氨酰胺 序贯肠内营养治疗 营养状态 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]