早期肠内营养联合双歧杆菌微生态制剂对重症监护病房慢性阻塞性肺疾病急性加重期患者胃肠功能免疫功能及炎症应激反应的影响  

Effects of early enteral nutrition combined with bifidobacterium microecological preparations on gastrointestinal function,immune function,and inflammatory stress response in AECOPD patients in ICU

作　　者：雷灵君 毛小娇 吴晗 Lei Lingjun;Mao Xiaojiao;Wu Han(Department of Respiratory and Critical Care Medicine,Lishui Second People′s Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市第二人民医院呼吸与重症医学科,浙江丽水323000

出　　处：《中国药物与临床》2024年第21期1374-1378,共5页Chinese Remedies & Clinics

基　　金：浙江省丽水市科技计划项目(2022SJZC048)。

摘　　要：目的分析早期肠内营养联合双歧杆菌微生态制剂对重症监护病房(ICU)慢性阻塞性肺疾病急性加重期(AECOPD)患者胃肠功能、免疫功能及炎性因子水平的影响。方法回顾性分析2021年1月至2022年12月浙江省丽水市第二人民医院ICU收治的150例AECOPD患者的临床资料,根据入院时间将其分为观察组(2021年1月至12月)与对照组(2022年1月至12月)各75例,对照组给予早期肠内营养治疗,观察组在对照组基础上联合双歧杆菌微生态制剂进行治疗。对比2组患者治疗前后急性生理与慢性健康评分(APACHEⅡ评分)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TF)、血清胃泌素(GAS)、胃动素(MTL)、胆囊收缩素(CCK)、免疫球蛋白(IgA、IgG、IgM)、白细胞介素(IL)-6、IL-1β和肿瘤坏死因子-α(TNF-α)的变化。结果2组患者治疗前胃肠功能等指标水平差异均无统计学意义(P>0.05),治疗后2组患者APACHEⅡ评分、营养状态、胃肠功能、免疫功能、炎症因子水平均得到显著改善;观察组治疗后ALB、PA、TF、MTL、IgA、IgG、IgM水平高于对照组(t=3.934,3.001,3.286,3.907,2.084,3.639,2.674,P均<0.05),APACHEⅡ得分、GAS、CCK、TNF-α、IL-1β和IL-6水平低于对照组(t=5.481,4.560,2.430,5.394,3.006,2.691,P均<0.05);观察组患者并发症发生率低于对照组(P<0.05)。结论早期肠内营养联合双歧杆菌微生态制剂治疗对ICU AECOPD患者胃肠功能、免疫功能的恢复有较好的促进作用,对机体炎症应激反应有较好的控制作用。ObjectiveTo explore the effects of early enteral nutrition combined with bifidobacterium microecological preparations on gastrointestinal function,immune function and inflammatory stress response in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in ICU.MethodsA retrospective analysis was performed on the clinical data of 150 patients with AECOPD admitted to ICU of the Lishui Second People′s Hospital from January 2021 to December 2022.According to different admission time,they were divided into a observation group(January-December 2021)and a control group(January-December 2022),75 cases in each group.The control group was treated with early enteral nutrition,while the observation group was addition-ally treated with bifidobacterium microecological preparations.The changes in APACHEⅡscores,levels of albumin(ALB),prealbumin(PA),transferrin(TF),serum gastrin(GAS),motilin(MTL),cholecystokinin(CCK),immunoglobulins(IgA,IgG,IgM),interleukin(IL)-6,IL-1βand tumor necrosis factor-α(TNF-α)before and after treatment were compared between the two groups.ResultsBefore treatment,there was no significant difference in any index between the two groups(P>0.05).After treatment,APACHEⅡscores,nutritional status,gastrointestinal function,immune function and inflammatory factors in both groups were significantly improved.After treatment,the levels of ALB,PA,TF,MTL,IgA,IgG and IgM in observation group were significantly higher than those in control group(t=3.934,3.001,3.286,3.907,2.084,3.639,2.674,all P<0.05),while APACHEⅡscore,the levels of GAS,CCK,IL-6,IL-1βand TNF-αwere significantly lower than those in control group(t=5.481,4.560,2.430,5.394,3.006,2.691,all P<0.05).The incidence of complications in observation group was significantly lower than that in control group(P<0.05).ConclusionEarly enteral nutri-tion combined with bifidobacterium microeco-logical preparations can effectively promote the recovery of gas-trointestinal function and immune function,and control inflammatory stress res

关 键 词：肺疾病 慢性阻塞性 胃肠活动 双歧杆菌微生态制剂 重症监护病房 

分 类 号：R563.9[医药卫生—呼吸系统]