早期肠内免疫微生物营养支持对高龄慢性心力衰竭急性发作患者营养状况、Th17/Treg细胞平衡的影响  

Effect of Early Enteral Immune Microbial Nutrition Support on Nutritional Status and Th17/Treg Balance in Elderly Patients with Acute Attack of Chronic Heart Failure

作　　者：韩丹宁 李芸瑶 HAN Dan-ning;LI Yun-yao(Xi'an Xihang Hospital of Universal,Xi'an Shaanxi 710021)

机构地区：[1]通用环球西安西航医院,陕西西安710021

出　　处：《医学临床研究》2023年第2期255-257,260,共4页Journal of Clinical Research

摘　　要：【目的】探讨早期肠内免疫微生物营养支持(EEN)对高龄慢性心力衰竭(CHF)急性发作患者营养状况、Th17/Treg细胞平衡的影响。【方法】选择2019年8月至2021年8月本院收治的106例高龄CHF急性发作患者,根据治疗方法的不同将其分为观察组(在常规抗心衰治疗基础上给予EEN)和对照组(常规抗心衰治疗),每组53例。比较两组临床疗效、心肌功能指标[左室收缩期末内径(LVESD)、左室射血分数(LVEF)、左室舒张期末内径(LVEDD)]、营养指标[白蛋白(ALB)、转铁蛋白(TF)、前白蛋白(PAB)]、免疫指标[调节性T细胞(Treg)、T辅助细胞17(Th17)、Th17/Treg]。【结果】观察组临床总有效率为92.45%(49/53),高于对照组的77.36%(41/53)(P=0.03)。治疗后,两组LVEDD、LVESD较治疗前降低,LVEF高于治疗前,且观察组与对照组比较,差异有统计学意义(P<0.05);两组血清TF、ALB、PAB水平高于治疗前,观察组高于对照组,差异有统计学意义(P<0.05);两组Th17、Th17/Treg水平低于治疗前,Treg水平高于治疗前,且观察组与对照组比较,差异有统计学意义(P<0.05)。【结论】早期肠内免疫微生物营养支持治疗高龄CHF急性发作患者临床效果显著,可改善患者心功能及机体营养不良状况,纠正免疫细胞失衡状态。【Objective】To study the effect of early enteral immune microbial nutrition support(EEN)on nutritional status and Th17/Treg balance in elderly patients with acute attack of chronic heart failure(CHF).【Methods】A total of 106 elderly patients with acute attack of CHF admitted to our hospital from August 2019 to August 2021 were selected as the research subjects.The patients were randomly divided into two groups with 53 cases in each group.The control group was given routine treatment,and the observation group was given EEN in addition to routine treatment.The curative effect,myocardial function indexes[left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],nutritional indexes[albumin(ALB),transferrin(TF),prealbumin(PAB)]and Immune response balance indicators[regulatory T cells(Treg),T helper cell 17(Th17),Th17/Treg ratio]were measured and compared between the two groups.【Results】The total clinical effective rate in the observation group was 92.45%(49/53),which was higher than that in the control group 77.36%(41/53)(P=0.03).After treatment,TF,ALB,PAB and LVEF in the observation group were higher than those in the control group(P<0.05).LVEDD and LVESD in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of Th17 and Th17/Treg in the observation group were lower than those before treatment,while the level of Treg was higher than that before treatment.The differences were statistically significant(P<0.05).【Conclusion】Early enteral immune microbial nutrition support is effective in the treatment of acute attack of CHF in the elderly.It can improve malnutrition,repair cardiac function and correct immune imbalance.

关 键 词：心力衰竭 慢性病 肠道营养 肠/微生物学 营养状况 T淋巴细胞亚群 

分 类 号：R541.61[医药卫生—心血管疾病]