不同肠内营养方式改善急性重症脑卒中患者营养、 免疫功能的效果研究  

Efficiencies of Different Methods of Enteral Nutrition on Improving Nutrition and Immune Function of Patients with Acute Severe Stroke

作　　者：陈二花[1] 李博[2] 王雄[2] 施雪英[2] CHEN Er-hua;LI Bo;WANG Xiong;SHI Xue-ying(Department of Clinical Nutrition,Anqing Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China;Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University,Anqing,Anhui 246000,China)

机构地区：[1]安徽医科大学附属安庆医院临床营养科,安徽安庆246000 [2]安徽医科大学附属安庆医院神经内科,安徽安庆246000

出　　处：《解放军医药杂志》2021年第8期96-100,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省科学技术厅项目(2018SF-015)。

摘　　要：目的探讨不同肠内营养方式对改善急性重症脑卒中患者营养、免疫功能的临床效果。方法选取2018年8月—2020年8月本院收治的急性重症脑卒中120例为研究对象,根据营养改善方案不同分为对照组58例及观察组62例,对照组给予肠内营养混悬液,观察组给予肠内营养乳剂。比较2组入院第1、7天C反应蛋白(CRP)、营养指标、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、T淋巴细胞亚群情况,并评估预后。结果与入院第1天比较,2组入院第7天CRP水平明显降低,且观察组低于对照组(P<0.05,P<0.01)。与入院第1天比较,入院第7天对照组IgG、IgA、IgM水平比较差异无统计学意义(P>0.05),但观察组IgG、IgA、IgM水平高于治疗前及对照组(P<0.05,P<0.01)。与入院第1天比较,2组入院第7天CD4+、CD4+/CD8+水平升高,CD8+水平降低,且观察组较对照组变化更显著(P<0.05,P<0.01)。与入院第1天比较,2组入院第7天总蛋白、血红蛋白均下降,前白蛋白升高,且观察组较对照组变化更显著(P<0.05,P<0.01)。观察组入院第7天白蛋白水平低于入院第1天及对照组(P<0.05)。与对照组比较,观察组多器官功能障碍综合征评分、急性生理学及慢性健康状况评分系统Ⅱ评分显著降低,格拉斯哥预后评分显著增高(P<0.01)。结论肠内营养乳剂可改善急性重症脑卒中患者营养状态、提高患者机体免疫功能,为疾病的治疗及康复创造了有利条件。Objective To explore efficiencies of different methods of enteral nutrition on improving nutrition and immune function of patients with acute severe stroke.Methods A total of 120 patients with acute severe stroke admitted between August 2018 and August 2020 were selected and divided into control group(n=58)and observation group(n=62)according to different methods of nutrition improvement.Control group was given enteral nutritional suspension,while observation group was given enteral nutrition emulsion.Levels of C reactive protein(CRP),nutritional indicators,immunoglobin G(IgG),immunoglobin A(IgA),immunoglobulin M(IgM)and T-lymphocyte subsets on the 1 st and 7 th d after admission were compared,and prognoses were evaluated in two groups.Results Compared with those on the 1 st d after admission,CRP levels were significantly lower on the 7 th d after admission in two groups,and the level in observation group was significantly lower than that in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,no significant differences were found in levels of IgG,IgA and IgM on the 7 th d after admission in control group(P>0.05),but levels of IgG,IgA and IgM in observation group were significantly higher than those before treatment in the same group and in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,levels of CD4+and CD4+/CD8+were significantly increased,while CD8+levels were significantly decreased on the 7 th d after admission in two groups,and the change in observation group were more significant than those in control group(P<0.05,P<0.01).Compared with those on the 1 st d after admission,TP and Hb levels were significantly decreased,while PA levels were significantly increased on the 7 th d after admission in two groups,and the changes in observation group were more significant than those in control group(P<0.05,P<0.01).Albumin level in observation group on the 7 th d after admission was significantly lower than that on the 1 st d after admission in the same group a

关 键 词：卒中 免疫球蛋白A 免疫球蛋白M 免疫球蛋白G C反应蛋白 T淋巴细胞亚群 白蛋白 前白蛋白 

分 类 号：R743[医药卫生—神经病学与精神病学]