肠内免疫微生态营养支持辅助治疗老年营养不良的效果及其抗炎机制  

Effect and anti-inflammatory mechanism of enteral immune microecological nutrition support in the treatment of senile malnutrition

作　　者：刘志超 窦现凤 赵海灵 LIU Zhi-chao;DOU Xian-feng;ZHAO Hai-ling(Department of Clinical Nutrition,Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical College),Xinxiang 453000,Henan,CHINA;Department of Gynecological Oncology,Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical College),Xinxiang 453000,Henan,CHINA)

机构地区：[1]新乡市中心医院(新乡医学院第四临床学院)临床营养科,河南新乡453000 [2]新乡市中心医院(新乡医学院第四临床学院)妇科肿瘤,河南新乡453000

出　　处：《海南医学》2024年第8期1086-1091,共6页Hainan Medical Journal

摘　　要：目的观察肠内免疫微生态营养(EIN)支持辅助治疗老年营养不良的效果并探讨其抗炎机制。方法选取2021年1月至2023年1月新乡市中心医院(新乡医学院第四临床学院)收治的103例老年营养不良患者纳入研究,采用随机数表法分为对照组(n=51)和观察组(n=52),对照组患者采取肠内营养(EN)支持,观察组患者采取EIN支持,连续治疗2周。比较两组患者治疗前、治疗2周后的人体测量指标[上臂围(AC)、小腿围(CC)、体质量指数(BMI)、肱三头肌皮褶厚度(TSF)]、营养生化指标[转铁蛋白(TF)、白蛋白(ALB)、淋巴细胞计数(LY)]、NRS2002评分、肠道微生态指标[双歧杆菌、乳酸杆菌、尿乳果糖/甘露醇(L/M)、二胺氧化酶(DAO)]和血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、降钙素原(PCT)、高敏C反应蛋白(hs-CRP)],同时比较两组患者的不良反应发生情况。结果治疗2周后,观察组患者的AC、CC、BMI、TSF分别为(23.58±2.47)cm、(27.78±3.50)cm、(19.06±1.77)kg/m^(2)、(8.58±0.95)mm,与对照组的(22.75±2.38)cm、(26.82±3.91)cm、(18.51±1.63)kg/m^(2)、(8.26±0.86)mm比较差异均无统计学意义(P>0.05);治疗2周后,观察组患者的血清TF、ALB、LY分别为(1.78±0.33)g/L、(35.60±4.48)g/L、(2.70±0.40)×10^(9)/L,明显高于对照组的(1.61±0.36)g/L、(32.71±4.09)g/L、(1.91±0.37)×10^(9)/L,差异均有统计学意义(P<0.05),但观察组患者的NRS 2002评分为(3.59±0.34)分,与对照组的(3.65±0.30)分比较,差异无统计学意义(P>0.05);治疗2周后,观察组患者的血清TNF-α、IL-10、PCT、hs-CRP水平分别为(55.56±4.43)ng/L、(26.61±2.46)ng/mL、(4.46±0.88)mg/L、(7.23±0.96)mg/L,明显低于对照组的(67.71±5.68)ng/L、(33.32±2.81)ng/mL、(6.13±0.95)mg/L、(9.56±1.01)mg/L,差异均具有统计学意义(P<0.05);治疗2周后,观察组患者的乳酸杆菌、双歧杆菌含量分别为(9.11±0.76)IgCFU、(9.25±0.81)IgCFU,明显高于对照组的(8.54±0.71)IgCFU、(8.Objective To observe the effect of enteral immune microecological nutrition(EIN)support in the treatment of malnutrition in the elderly and explore its anti-inflammatory mechanism.Methods A total of 103 elderly malnourished patients admitted to Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical Universi-ty)from January 2021 to January 2023 were selected for inclusion in the study.They were randomly divided into a con-trol group(n=51)and an observation group(n=52)using a random number table method.Patients in the control group received enteral nutrition(EN)support,while those in the observation group received EIN support.Both groups were treated continuously for 2 weeks.The anthropometric parameters[upper arm circumference(AC),calf circumference(CC),body mass index(BMI),triceps skinfold thickness(TSF)],nutritional biochemical parameters[transferrin(TF),al-bumin(ALB),lymphocyte count(LY)],NRS2002 score,intestinal microecological parameters[bifidobacteria,lactobacil-lus,urine lactulose/mannitol(L/M),diamine oxidase(DAO)],and serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP)]were compared be-tween the two groups before and after 2 weeks of treatment.The adverse reactions in the two groups were also com-pared.Results After 2 weeks of treatment,the AC,CC,BMI,and TSF of the patients in the observation group were(23.58±2.47)cm,(27.78±3.50)cm,(19.06±1.77)kg/m^(2),and(8.58±0.95)mm,respectively,which showed no statistically significant differences with(22.75±2.38)cm,(26.82±3.91)cm,(18.51±1.63)kg/m^(2),and(8.26±0.86)mm in the control group(P>0.05).After 2 weeks of treatment,the serum TF,ALB,and LY of the patients in the observation group were(1.78±0.33)g/L,(35.60±4.48)g/L,and(2.70±0.40)×10^(9)/L,respectively,which were significantly higher than(1.61±0.36)g/L,(32.71±4.09)g/L,and(1.91±0.37)×10^(9)/L of the control group(P<0.05).However,the NRS 2002 score of the patients in the observation group

关 键 词：肠内免疫微生态营养支持 老年营养不良 人体测量指标 营养生化指标 NRS2002评分 肠道微生态指标 血清炎症因子 

分 类 号：R153.3[医药卫生—营养与食品卫生学]