早期肠内营养支持对急性心肌梗死合并严重心力衰竭预后的影响研究  

A study of early enteral nutrition support on prognosis of acute myocardial infarction patients with severe heart failure

作　　者：朱京东 周昱和 陈群 王立群 ZHU Jing-dong;ZHOU Yu-he;CHEN Qun;WANG Li-qun(Division of Cardiology,Nanjing General Hospital of the PLA,Nanjing 210002,Jiangsu,China;Wounded and Sick Management Section,Nanjing General Hospital of the PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院,心血管内科,江苏南京210002 [2]东部战区总医院,伤病员管理科,江苏南京210002

出　　处：《肠外与肠内营养》2024年第6期341-345,352,共6页Parenteral & Enteral Nutrition

摘　　要：目的:探讨早期肠内营养支持对急性心肌梗死合并严重心力衰竭病人预后的影响。方法:回顾性分析东部战区总医院心血管内科2019年5月~2021年5月收治的86例急性心肌梗死合并严重心力衰竭病人资料,按照AGI评分进行分组,分为肠外营养组和早期肠内营养组,各43例,治疗2周后,比较两组病人一般人口学特征、治疗前后的营养状况[前白蛋白(PA)和血清白蛋白(ALB)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)和高射血分数率(PER)]及血清氨基末端脑钠肽前体(NT-proBNP)水平,并统计两组治疗预后转归情况,即ICU转至普通病房率及存活率。结果:两组治疗前营养指标对比差异无统计学意义(P>0.05);两组治疗后PA、ALB水平较治疗前有所升高,其中早期肠内营养组PA、ALB水平均高于肠外营养组,差异有统计学意义(P<0.05);两组治疗前心功能指标水平对比无明显差异(P>0.05);早期肠内营养组治疗后LVEF水平高于肠外营养组,LVESD和PER水平低于肠外营养组(P<0.05);两组治疗前NT-proBNP水平对比无明显差异(P>0.05);早期肠内营养组治疗后NT-proBNP水平低于肠外营养组(P<0.05);治疗后早期肠内营养组ICU转至普通病房率及存活率明显高于肠外营养组(P<0.05)。结论:早期肠内营养支持可有效改善急性心肌梗死合并严重心力衰竭病人的营养状态,促进心功能恢复,增加存活率。Objective:To investigate the effect of early enteral nutrition support on the prognosis of patients with acute myocardial infarction with severe heart failure.Methods:The data of 86 patients with acute myocardial infarction combined with severe heart failure admitted from May 2019 to May 2021 were retrospective reviewed.According to AGI scores,they were divided into parenteral nutrition group and early enteral nutrition group,with 43 cases in each group.The general demographic characteristics,nutritional status before and after treatment[prealbumin(PA)and serum albumin(ALB)],cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)and high ejection fraction rate(PER)]and serum amino-terminal brain natriuretic peptide precursor(NT-proBNP)levels were compared between the two groups,i.e.the rate of ICU transfer to the general ward and the survival rate,were analyzed.Results:There was no statistical difference in nutritional indexes between the two groups before treatment(P>0.05).After treatment,the levels of PA and ALB in the two groups were higher than before treatment,and the levels of PA and ALB in the early enteral nutrition group were higher than those in the parenteral nutrition group,the difference was statistically significant(P<0.05).There was no significant difference in the level of cardiac function index between the two groups before treatment(P>0.05).After treatment,LVEF levels in early enteral nutrition group were higher than those in parenteral nutrition group,LVESD and PER levels were lower than those in parenteral nutrition group(P<0.05).There was no significant difference in the level of NT-proBNP between the two groups before treatment(P>0.05).The level of NT-proBNP in early enteral nutrition group was lower than that in parenteral nutrition group(P<0.05).After treatment,the rate of ICU transfer to general ward and survival rate in early enteral nutrition group were significantly higher than those in parenteral nutrition group(P<0.05).Conclu

关 键 词：早期肠内营养支持 急性心肌梗死 心力衰竭 预后 

分 类 号：R459.3[医药卫生—治疗学]