高单不饱和脂肪酸液体鼻饲对急性脑卒中取栓术后患者糖脂代谢影响的动态分析  

Dynamic analysis of the effect of high monounsaturated fatty acid liquid nasal feeding on glycolipid metabolism in acute stroke patients after thrombectomy

作　　者：宋保平 钱会娟[2] 陈勤勤[1] 吴云飞 王岚[1] Song Bao-ping;Qian Hui-juan;Chen Qin-qin;Wu Yun-fei;Wang Lan(Department of Neurology,Shanghai Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海上海市第六人民医院神经内科,上海200233 [2]上海上海市第六人民医院护理部,上海200233

出　　处：《中国急救医学》2023年第5期365-369,共5页Chinese Journal of Critical Care Medicine

基　　金：上海市第六人民医院院级科学研究基金(x院内-2516)。

摘　　要：目的 动态分析高单不饱和脂肪酸液体鼻饲对急性脑卒中取栓术后患者糖脂代谢的影响。方法 纳入2021年1月至2022年9月上海市第六人民医院100例脑卒中取栓术后患者为研究对象,采用随机数字表法随机分为对照组和干预组,每组50例。对照组采用传统鼻饲方案进行肠内营养支持治疗,干预组予以高单不饱和脂肪酸液体鼻饲喂养。动态监测两组糖脂代谢指标,分析高单不饱和脂肪酸液体饮食对急性脑卒中患者糖脂代谢影响,并比较两组患者营养指标、氧化应激指标及不良反应。结果 两组第1个24 h血糖及胆固醇变异系数比较差异无统计学意义(P>0.05),第2个24 h及第3个24 h血糖及胆固醇变异系数干预组低于对照组(P<0.05);鼻饲结束后,两组内皮型一氧化氮合酶(eNOS)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平均改善,且干预组MDA水平低于对照组,eNOS、SOD水平高于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 高单不饱和脂肪酸液体鼻饲可为急性脑卒中取栓术后患者提供营养,并可有效维持糖脂代谢平衡,降低患者应激反应,且不增加患者不良反应发生率。Objective To dynamically analyze the effects of high monounsaturated fatty acid liquid nasal feeding on glycolipid metabolism in acute stroke patients after thrombectomy.Methods From January 2021 to September 2022,100 patients with cerebral apoplexy after thrombectomy in our hospital were selected as the research objects and were randomly divided into control group and intervention group with 50 cases in each group.The control group was given enteral nutrition support by traditional nasal feeding scheme,while the intervention group was given high monounsaturated fatty acid liquid nasal feeding.The indexes of glucose and lipid metabolism in two groups were monitored dynamically,and the effect of high monounsaturated fatty acid liquid diet on glucose and lipid metabolism in the patients with acute stroke was analyzed.The nutritional indexes,oxidative stress indexes and adverse reactions of the two groups were compared.Results There were no significant differences in the variation coefficients of blood glucose and cholesterol between the two groups in the first 24 h(P>0.05),but the variation coefficients of blood glucose and cholesterol in the second 24 h and the third 24 h in the intervention group were lower than those in the control group(P<0.05).After nasal feeding,the levels of endothelial nitric oxide synthase(eNOS),malondialdehyde(MDA) and superoxide dismutase(SOD) in both groups were improved,and the MDA in the intervention group was lower than that in the control group,but the levels of eNOS and SOD in the intervention group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Nasal feeding with high monounsaturated fatty acid liquid can provide nutrients for acute stroke patients after thrombectomy,and effectively maintain the metabolic balance of glycolipid,reduce stress response in the patients,and does not increase the incidence of adverse reactions.

关 键 词：急性脑卒中 取栓 高单不饱和脂肪酸液体 鼻饲 糖脂代谢 动态分析 内皮型一氧化氮合酶(eNOS) 丙二醛(MDA) 超氧化物歧化酶(SOD) 

分 类 号：R651.12[医药卫生—外科学]