谷氨酰胺肠内营养联合低分子肝素对老年慢性阻塞性肺疾病并发重症肺部感染患者炎症与氧化应激反应的影响  

Effect of glutamine enteral nutrition combined with heparin on inflammation and oxidative stress in elderly patients with severe pulmonary infection and chronic obstructive pulmonary disease

作　　者：连晓峰[1] 韩鹏[1] 李永锋[1] 许志强[1] LIAN Xiaofeng;HAN Peng;LI Yongfeng;XU Zhiqiang(Department of Respiratory and Critical Care Medicine,Anyang District Hospital,Anyang,Henan 455000,China)

机构地区：[1]河南省安阳地区医院呼吸与危重症医学科,河南安阳455000

出　　处：《中国医学工程》2021年第1期33-36,共4页China Medical Engineering

摘　　要：目的观察谷氨酰胺肠内营养联合低分子肝素对老年慢性阻塞性肺疾病(COPD)并发重症肺部感染患者炎症与氧化应激反应的影响分析。方法将安阳地区医院2016年01月至2018年12月收治的COPD并发重症感染患者150例,根据患者入院治疗顺序分成对照组与实验组各75例,其中对照组患者采取常规治疗基础上联合低分子肝素治疗,实验组采取常规治疗上谷氨酰胺肠内营养联合低分子肝素治疗。对照两组患者治疗前、后机体内免疫功能指标[免疫球蛋白G(IgG)、免疫球蛋白M (IgM)、免疫球蛋白A (IgA)、CD4/CD8]、炎性反应指标[白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α);使用免疫比浊发检测C-反应蛋白(CRP)]、氧化应激反应指标[超氧歧化酶(SOD)、血清丙二醛(MDA)]、肺功能指标[肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、FEV_1/FVC]及临床治疗效果。结果治疗后两组患者免疫功能指标均明显提高,实验组各项免疫功能指标高于对照组;治疗后两组患者炎性反应指标均明显下降,实验组患者各项炎性反应指标低于对照组;治疗后两组患者氧化应激反应指标均明显改善,实验组患者SOD反应指标高于对照组,MDA指标低于对照组;治疗后两组患者肺功能相关指标均明显改善,实验组优于对照组;实验组患者临床总有效率为97.33%,对照组为82.67%(P<0.01)。结论采取谷氨酰胺肠内营养联合肝素治疗COPD并发重症肺部感染患者,可明显提高患者机体免疫功能指标,减少机体内炎性反应指标,调节机体氧化应激指标,进而改善肺功能指标,提高患者临床治疗有效率,效果理想。【Objective】To observe the effect of glutamine enteral nutrition combined with heparin on inflammation and oxidative stress in patients with chronic obstructive pulmonary disease complicated with severe pulmonary infection.【Methods】A total of 150 patients with chronic obstructive pulmonary disease(COPD)complicated with severe infection treated in our hospital from January 2016 to December 2018 were selected.They were divided into control group(75 cases)and experimental group(75 cases)according to the order of admission.The patients in control group were treated with heparin on the basis of routine treatment,while those in experimental group were treated with glutamine enteral nutrition combined with heparin on the basis of routine treatment.The indexes of immune function(IgG,IgM,IgA,CD4/CD8),inflammatory response(IL-6,TNF-alpha,CRP),oxidative stress response(SOD,MDA),lung function(VC,FVC,FEV1,FEV1/FVC)and clinical therapeutic effect were compared between the two groups before and after treatment.【Results】After treatment,the indexes of immune function in the two groups were significantly improved.The indexes of immune function in the experimental group were significantly higher than those in the control group,and the indexes of inflammatory reaction in the experimental group were significantly lower than those in the control group.The indexes of oxidative stress reaction in the two groups were significantly improved,and the SOD response index was significantly higher,the MDA index was significantly lower in the experimental group than in the control group.The pulmonary function indexes of the experimental group were significantly higher than those of the control group.The total clinical effective rate of the experimental group was 97.33%,and that of the control group was 82.67%,and the difference was statistically significant(P<0.01).【Conclusion】Glutamine enteral nutrition combined with heparin in the treatment of COPD patients with severe pulmonary infection can significantly improve the body's imm

关 键 词：谷氨酰胺肠内营养 低分子肝素联合治疗 慢性阻塞性肺疾病 并发重症肺部感染 炎症与氧化应激反应 

分 类 号：R563[医药卫生—呼吸系统]