肠内营养乳剂对呼吸机支持治疗重症肺炎患者营养及免疫指标的影响  

Effects of enteral nutrition emulsion on nutrition and immune indexes of patients with severe pneumonia undergoing ventilator support treatment

作　　者：孔华玮 高虹 杨拴盈[2] KONG Hua-wei;GAO Hong;YANG Shuan-ying(The Fourth Department of Internal Medicine,People's Hospital of Lintong District of Xi'an,Xi'an 710600,Shaanxi,CHINA;Department of Respiratory and Critical Care Medicine,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi,CHINA)

机构地区：[1]西安市临潼区人民医院内四科,陕西西安710600 [2]西安交通大学第二附属医院呼吸与危重症医学科,陕西西安710004

出　　处：《海南医学》2020年第21期2746-2749,共4页Hainan Medical Journal

摘　　要：目的研究肠内营养乳剂对呼吸机支持治疗重症肺炎患者血清白蛋白(ALB)、前白蛋白(PA)水平和T淋巴细胞亚群的影响。方法选取2017年1月至2018年12月西安市临潼区人民医院确诊为肺部感染致呼吸衰竭患者100例,按随机数表法分为观察组和对照组各50例,两组患者均接受呼吸机支持治疗,观察组同时给予鼻肠营养管滴注肠内营养液,对照组给予静脉注射全营养液。治疗14 d后,比较两组患者治疗效果,并检测两组患者治疗前后的免疫和营养学相关指标,并记录治疗期间并发症情况。结果治疗后,观察组患者的治疗总有效率为94.0%,明显高于对照组的80.0%,差异有统计学意义(P<0.05);治疗后,观察组患者血清中ALB、PA、载脂蛋白A1(ApoA1)、CD3+、CD4+、CD4+/CD8+分别为(212.38±25.64)mg/L、(37.47±1.22)g/L、(1.53±0.38)g/L、(67.12±5.64)%、(38.43±5.52)%、1.71±0.38,明显高于对照组的(168.34±18.27)mg/L、(32.01±1.09)g/L、(1.24±0.37)g/L、(58.34±4.67)%、(34.01±6.09)%、1.52±0.31,降钙素原(PCT)、C反应蛋白(CRP)、CD8+分别为(0.88±0.14)ng/L、(3.47±0.42)mg/L、(22.47±3.88)%,明显低于对照组的(1.34±0.28)ng/L、(5.01±0.39)mg/L、(26.84±3.37)%,差异均有统计学意义(P<0.05);治疗过程中观察组患者的高血糖发生率为2.0%,明显低于对照组的16.0%,差异有统计学意义(P<0.05)。结论肠内营养乳剂支持能够显著改善呼吸机支持治疗重症肺炎患者的免疫及营养状态,且并发症发生率低。Objective To study the effects of enteral nutrition emulsion on serum albumin(ALB),prealbumin(PA)levels,and T lymphocyte subsets in severe pneumonia patients undergoing ventilator support treatment.Methods A total of 100 patients with respiratory failure induced by pulmonary infection who were confirmed in People's Hospital of Lintong District of Xi'an from January 2017 to December 2018 were enrolled.They were divided into the observation group and control group by random number table method,with 50 patients in each group.Both groups underwent ventilator support treatment.The observation group was given enteral nutrient solution through nasal enteral nutrition tube,while the control group was given intravenous injection of total nutrient solution.After 14 d of treatment,response rate of treatment was compared between the two groups.Immune and nutriology related indexes before and after treatment in both groups were detected.The complications during treatment were recorded.Results After treatment,the total response rate of the observation group was significantly higher than that of control group(94.0%vs 80.0%,P<0.05).The levels of serum ALB,PA,apolipoprotein A1(ApoA1),CD3+,CD4+and CD4+/CD8+in the observation group were(212.38±25.64)mg/L,(37.47±1.22)g/L,(1.53±0.38)g/L,(67.12±5.64)%,(38.43±5.52)%and(1.71±0.38),respectively,which were significantly higher than corresponding(168.34±18.27)mg/L,(32.01±1.09)g/L,(1.24±0.37)g/L,(58.34±4.67)%,(34.01±6.09)%,1.52±0.31 in the control group(all P<0.05),while the levels of procalcitonin(PCT),C-reactive protein(CRP),and CD8+in the observation group were(0.88±0.14)ng/L,(3.47±0.42)mg/L,and(22.47±3.88)%,respectively,which were significantly lower than corresponding(1.34±0.28)ng/L,(5.01±0.39)mg/L,(26.84±3.37)%in the control group(all P<0.05).During treatment,the incidence of hyperglycemia in the observation group was significantly lower than that in control group(2.0%vs 16.0%,P<0.05).Conclusion Enteral nutrition emulsion support can significantly improve immune and

关 键 词：重症肺炎 呼吸机支持 肠内营养乳剂 营养状态 免疫功能 

分 类 号：R563.1[医药卫生—呼吸系统]