低糖高脂营养治疗对老年慢性阻塞性肺疾病急性加重期并发呼吸衰竭患者肺功能及免疫力的影响  

Effects of low - carbohydrate and high - fat nutritional therapy on pulmonary function and immunity in elderlypatients with acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure

作　　者：王军[1] 周春香[2] 张晓枫 WANG Jun;ZHOU Chun-xiang;ZHANG Xiao-feng(Department of Respiratory and Critical Care Medicine,Suzhou Kowloon Hospital Affiliated to Medical College of Shanghai Jiao Tong University,Suzhou 215028,Jiangsu,China;Department of Respiratory,Affiliated Hospital of Jiangnan University,Wuxi 214062,Jiangsu,China)

机构地区：[1]上海交通大学医学院苏州九龙医院呼吸与危重症医学科,江苏省苏州市215028 [2]江南大学附属医院呼吸科,江苏省无锡市214062

出　　处：《广西医学》2022年第17期1978-1981,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81500071)。

摘　　要：目的 探讨低糖高脂营养治疗对老年慢性阻塞性肺疾病急性加重期(AECOPD)并发呼吸衰竭患者肺功能及免疫力的影响。方法 选取老年AECOPD并发呼吸衰竭患者162例,随机分为对照组和观察组,各81例。在常规治疗基础上,对照组给予常规营养干预,观察组给予低糖高脂营养干预。比较两组治疗前后肺功能、血气指标、免疫指标的差异。结果 治疗后,两组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)占FVC百分比(FEV_(1)/FVC)均较治疗前升高,且观察组患者FVC、FEV_(1)、FEV_(1)/FVC均高于对照组,观察组肺部二氧化碳排出量和最大摄氧量均低于对照组(均P<0.05);两组患者PaO_(2)水平较治疗前升高,且观察组PaO_(2)水平高于对照组,而PaCO_(2)水平低于对照组(均P<0.05)。观察组患者治疗后的IgG水平、CD4^(+)T淋巴细胞水平、CD4^(+)/CD8^(+)比值均较治疗前升高,且均高于对照组(均P<0.05)。结论 在常规治疗基础上,给予老年AECOPD并发呼吸衰竭患者低糖高脂营养治疗可以提高患者免疫力,更好地改善肺功能。Objective To investigate the effects of low-carbohydrate and high-fat nutritional therapy on pulmonary function and immunity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods A total of 162 elderly AECOPD patients complicated with respiratory failure were selected,and they were randomly divided into control group or observation group,with 81 cases in each group.On the basis of routine treatment,the control group received routine nutritional intervention,and the observation group received low-carbohydrate and high-fat nutritional intervention.The pre-and post-treatment differences of pulmonary function,blood gas indices,and immune indices were compared between the two groups.Results After treatment,the forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),the ratio of FEV_(1) to FVC(FEV_(1)/FVC)were elevated in both groups as compared with before treatment,and the observation group exhibited higher FVC,FEV_(1),and FEV_(1)/FVC,whereas lower pulmonary carbon dioxide discharge and maximal oxygen uptake as compared with the control group(all P<0.05).After treatment,the level of PaO_(2) was elevated in both groups as compared with before treatment,and the observation group interpreted a higher PaO_(2) level,whereas a lower level of PaCO_(2) as compared with the control group(all P<0.05).The observation group yielded higher post-treatment levels of IgG level,CD4^(+)T lymphocyte level,CD4^(+)/CD8^(+)ratio as compared with before treatment, and the above indices were higher in the observation group than in the control group ( all P <0. 05) . Conclusion On thebasis of routine treatment,low-carbohydrate and high-fat nutritional therapy for elderly AECOPD patients complicatedwith respiratory failure can improve patients' immunity,and preferably ameliorate pulmonary function.

关 键 词：低糖高脂 营养治疗 慢性阻塞性肺疾病急性加重期 呼吸衰竭 肺功能 免疫功能 老年人 

分 类 号：R563[医药卫生—呼吸系统]