脂肪乳剂联合复方氨基酸注射液对心脏瓣膜病患者术后营养参数和炎症免疫以及预后的影响  

Effects of Adjuvant Treatment with Fat Emulsion and Compound Amino Acid Injection on Postoperative Nutrition,Inflammation,Immunity and Prognosis of Patients with Valvular Heart Disease

作　　者：张汝 严中亚 卢中 Zhang Ru;Yan Zhongya;Lu Zhong(Department of Cardiac and Vascular Surgery,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院心脏大血管外科,合肥230601

出　　处：《成都医学院学报》2024年第4期662-665,共4页Journal of Chengdu Medical College

基　　金：2023年度安徽省卫生健康委员会科研项目(No:AHWJ2023BAb20009);合肥市综合性国家科学中心大健康研究院基金项目(No:ZDQY2301)。

摘　　要：目的研究在肠内营养(EN)治疗基础上使用脂肪乳剂和复方氨基酸注射液对心脏瓣膜病(VHD)患者术后营养状况、炎症免疫及预后的影响。方法选取2019年1月至2021年1月安徽医科大学第二附属医院收治的VHD合并营养不良的患者共92例,随机分为试验组和对照组,每组各46例。对照组接受EN治疗,试验组在EN基础上经静脉注射脂肪乳氨基酸(17)葡萄糖(11%)注射液治疗,比较两组患者术后7 d时的营养参数、炎症因子、免疫功能指标、预后及并发症。结果治疗后,试验组血红蛋白、白蛋白、前白蛋白、转铁蛋白、三头肌皮褶厚度、上臂围、上臂肌围均高于对照组(P<0.05),血清降钙素原、白细胞介素-6、超敏C反应蛋白均低于对照组(P<0.05);试验组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。住院期间,对照组患者无死亡,试验组患者死亡1例(2.17%),两组患者病死率、并发症发生率比较,差异无统计学意义(P>0.05)。结论脂肪乳剂联合复方氨基酸注射液治疗VHD患者可减轻患者炎症反应,提高其免疫功能,同时不会导致患者预后不良。Objective To study the effects of adjuvant treatment with fat emulsion and compound amino acid injection on the postoperative nutrition,inflammation,immunity and prognosis of patients with valvular heart disease(VHD)on the basis of enteral nutrition(EN).Methods A total of 92 patients with VHD and malnutrition who underwent heart valve replacement in the Second Affiliated Hospital of Anhui Medical University from January 2019 to January 2021 were selected.They were randomly divided into the experimental group(n=46)and the control group(n=46).The control group received EN treatment,while the experimental group received intravenous injection of fat emulsion amino acid(17)glucose(11%)on the basis of EN treatment.The nutritional parameters,inflammatory factors,and immune function indicators at the 7th day after surgery,as well as the prognosis and incidence of complications were compared between the two groups.Results After treatment,the hemoglobin(Hb),albumin(ALB),prealbumin(PA),transferrin(TRF),triceps skinfold(TSF),arm circumference(AC),and arm muscle circumference(ACM)in the experimental group were higher than those in the control group(P<0.05).The serum procalcitonin(PCT),interleukin-6(IL-6),and hypersensitive C-reactive protein(hs-CRP)in the experimental group were lower than those in the control group(P<0.05).The CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the experimental group were higher than those in the control group,while CD8^(+)in the experimental group was lower than that in the control group(P<0.05).No death occurred in the control group during hospitalization,but there was 1(2.17%)death case in the experimental group(P>0.05).There was no signficant difference in mortality and incidence of complications between the two groups(P>0.05).Conclusion Adjuvant treatment with fat emulsion and compound amino acid injection can alleviate inflammatory response and enhance immunity in patients with VHD,and does not lead to poor prognosis.

关 键 词：心脏瓣膜病 营养支持 炎症 免疫 预后 

分 类 号：R542.5[医药卫生—心血管疾病]