含ω-3多不饱和脂肪酸早期肠内营养对老年重症肺炎患者机械通气时间与炎性因子及免疫功能的影响  

Effects of early enteral nutrition containingω-3PUFA on mechanical ventilation time,inflammatory factors and immune function in elderly patients with severe pneumonia

作　　者：刘端绘 莫毅[1] 陈泽宇[1] 梁振杰[1] 王勇湘 陈再钊 Liu Duanhui;Mo Yi;Chen Zeyu;Liang Zhenjie;Wang Yongxiang;Chen Zaizhao(Department of Critical Medicine,Wuzhou Red Cross Hospital,Wuzhou 543002,China)

机构地区：[1]广西梧州市红十字会医院重症医学科,梧州543002

出　　处：《中国临床保健杂志》2021年第1期80-84,共5页Chinese Journal of Clinical Healthcare

基　　金：广西壮族自治区卫生健康委员会科研项目(Z20190639)。

摘　　要：目的探讨含ω-3多不饱和脂肪酸(ω-3PUFA)早期肠内营养对老年重症肺炎患者机械通气时间、炎性因子及免疫功能的影响。方法选取2017年10月至2020年3月梧州市红十字会医院收治的100例老年重症肺炎患者为对象,按照随机数字表法分为对照组(n=50)和观察组(n=50),对照组给予早期肠内营养支持,观察组营养液中富含ω-3多不饱和脂肪酸,比较两组机械通气时间、ICU住院时间、脱机成功率、多脏器功能障碍(MODS)发生率、营养指标[血红蛋白(HGB)、白蛋白(ALB)、前清蛋白(PAB)]、炎性因子[白细胞介素6(IL-6)、白细胞介素1(IL-1)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)]、免疫功能及不良反应发生率。结果观察组机械通气时间和ICU住院时间短于对照组(P<0.05),两组脱机成功率和MODS发生率差异无统计学意义(P>0.05);治疗后,观察组HGB、ALB、PAB水平均高于对照组(P<0.05),观察组血清IL-6、IL-1、TNF-α及CRP水平均低于对照组(P<0.05),观察组CD3+、CD4+、CD4+/CD8+均显著高于对照组,CD8+低于对照组(P<0.05);两组均无不良反应发生(P>0.05)。结论ω-3PUFA早期肠内营养可缩短老年重症肺炎患者机械通气时间,减低炎性因子,提高细胞免疫功能。Objective To explore effects of early enteral nutrition containingω-3 polyunsaturated fatty acids(ω-3PUFA)on mechanical ventilation time,inflammatory factors and immune function in elderly patients with severe pneumonia.Methods A total of 100 elderly patients with severe pneumonia who were admitted to the hospital from October 2017 to March 2020 were enrolled.According to random number method,they were divided into control group(n=50)and observation group(n=50).The control group was given early enteral nutrition support.In observation group,richω-3PUFA was added into nutrient solution.The mechanical ventilation time,hospitalization time in ICU,success rate of weaning,incidence of multiple organ dysfunction syndrome(MODS),nutrition indexes[hemoglobin(HGB),albumin(ALB),prealbumin(PAB)],inflammatory factors[interleukin-6(IL-6),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],immune function and incidence of adverse reactions were compared between the two groups.Results The mechanical ventilation time and hospitalization time in ICU in observation group were shorter than those in control group(P<0.05).There was no significant difference in success rate of weaning or incidence of MODS between the two groups(P>0.05).After treatment,levels of HGB,ALB and PAB in observation group were higher than those in control group(P<0.05),levels of serum IL-6,IL-1,TNF-αand CRP were lower than those in control group(P<0.05),CD3+,CD4+and CD4+/CD8+were significantly higher than those in control group(P<0.05).There were no adverse reactions in either group(P>0.05).Conclusion Early enteral nutrition containingω-3PUFA can shorten mechanical ventilation time,reduce inflammatory factors,and improve immune function in elderly patients with severe pneumonia.

关 键 词：肺炎 肠道营养 脂肪酸类 ω3 老年人 

分 类 号：R563.1[医药卫生—呼吸系统] R459.3[医药卫生—内科学]