分离乳清蛋白粉与普通蛋白质粉对颌面部骨折内固定术后病人免疫功能和临床结局的影响  

Effects of whey protein powder and ordinary protein powder on the immune function and clinical outcome of patients after internal fixation of maxillofacial fractures

作　　者：雍雪飞[1] 张红[2] 王燕 YONG Xue-fei;ZHANG Hong;WANG Yan(Department of Nutrition,Chengdu Sixth People's Hospital,Chengdu Sichuan 610000,China;Health Management Center,Chengdu Sixth People's Hospital,Chengdu Sichuan 610000,China;Department of Orthopedics,People's Hospital of Chongqing Shuangqiao Economic and Technological Development Zone,Chongqing 400900,China)

机构地区：[1]成都市第六人民医院营养科,四川成都610000 [2]成都市第六人民医院健康管理中心,四川成都610000 [3]重庆市双桥经济技术开发区人民医院骨科,重庆400900

出　　处：《临床和实验医学杂志》2021年第20期2208-2212,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省科技计划项目(编号:2019YJ0659)。

摘　　要：目的分析分离乳清蛋白粉与普通蛋白质粉对颌面部骨折患者内固定术后免疫功能和临床结局的影响。方法回顾性选取2019年3月至2020年11月成都市第六人民医院收治的80例颌面部骨折患者,按照治疗方式分为2组,对照组40例,内固定术后采用普通匀浆膳+普通蛋白质粉进行肠内营养支持,观察组40例,内固定术后采用普通匀浆膳+分离乳清蛋白粉进行肠内营养支持。观察并记录2组患者术后1 d和14 d的免疫功能指标[免疫球蛋白(Ig)A、IgG、IgM、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)]、营养指标[血清总蛋白(TP)、血红蛋白(Hb)、前白蛋白(PAB)、白蛋白(ALB)]、住院时间、创口愈合时间、颌面部功能恢复时间及不良反应发生情况。结果2组患者术后14 d的IgA、IgG、IgM、CD4^(+)及CD4^(+)/CD8^(+)水平均较术后1 d明显降低,CD8^(+)水平较术后1 d明显升高,差异均有统计学意义(P<0.05),且观察组术后14 d的IgA、IgG、IgM、CD4^(+)及CD4^(+)/CD8^(+)水平明显高于对照组,CD8^(+)水平明显低于对照组,差异均有统计学意义(P<0.05)。2组患者术后14 d的TP、Hb、PAB、ALB水平均较术后1 d明显上升,差异均有统计学意义(P<0.05),且观察组术后14 d的TP、Hb、PAB、ALB水平上升幅度更明显,差异均有统计学意义(P<0.05)。观察组患者住院时间、窗口愈合时间和颌面部功能恢复时间显著短于对照组,差异均有统计学意义(P<0.05)。2组不良反应总发生率相比差异无统计意义(P>0.05)。结论分离乳清蛋白粉更能有效改善颌面部骨折患者内固定术后免疫功能,优化患者临床结局,值得临床予以推广应用。Objective To analyze the influence of whey protein powder and ordinary protein powder on the immune function and clinical outcome of patients with maxillofacial fracture after internal fixation.Methods Eighty cases of maxillofacial fracture patients admitted to Chengdu Sixth People's Hospital from March 2019 to November 2020 were retrospectively selected and divided into two groups according to the random number table method.The control group(40 cases)was given enteral nutrition support with common homogenate diet+common protein powder after internal fixation,and the observation group(40 cases)was given enteral nutrition support with common homogenate diet+separated whey protein powder after internal fixation.The immune function indexes of the two groups of patients at 1,14 days after operation[immunoglobulin(Ig)A,IgG,IgM,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)],nutritional indicators[total protein(TP),hemoglobin(Hb),prealbumin(PAB),albumin(albumin,ALB)],hospitalization time,window healing time,maxillofacial function recovery time and adverse reactions were observed and recorded.Results The levels of IgA,IgG,IgM,CD4^(+)and CD4^(+)/CD8^(+)at 14 days after operation in the two groups were significantly lower than those at the 1 day after operation,and the levels of CD8^(+)at 14 days after operation were significantly higher than those at 1 day after operation,the differences were statistically significant(P<0.05).The levels of IgA,IgG,IgM,CD4^(+)and CD4^(+)/CD8^(+)at 14 days after operation in the observation group were significantly higher than those in the control group,and the levels of CD8^(+)at 14 days after operation in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of TP,Hb,PAB,and ALB at 14 d after operation in the two groups were significantly higher than those at 1 d after operation,and the differences were statistically significant(P<0.05),and the levels of TP,Hb,PAB,ALB at 14 d after operation in the observa

关 键 词：颌面部骨折 分离乳清蛋白粉 普通蛋白质粉 免疫功能 临床结局 

分 类 号：R782.4[医药卫生—口腔医学]