不同营养支持途径HBV感染相关肝硬化患者TGF-β1、SIL-2R、GP73水平及其治疗效果  

Effect of different nutritional support routes on TGF-β1,SIL-2R and GP73 and their therapeutic effects in patients with HBV infection-related cirrhosis

作　　者：王芳 叶云 谭友文 丁加琪 张颖[1] 夏燕[4] WANG Fang;YE Yun;TAN Youwen;DING Jiaqi;ZHANG Ying;XIA Yan(Jiangsu University,Zhenjiang,Jiangsu 212013,China;不详)

机构地区：[1]江苏大学医学院,江苏镇江212013 [2]江苏大学附属镇江三院护理部,江苏镇江212005 [3]江苏大学附属镇江三院肝科,江苏镇江212005 [4]泰州市第四人民医院营养科,江苏泰州225399

出　　处：《中华医院感染学杂志》2025年第4期501-506,共6页Chinese Journal of Nosocomiology

基　　金：江苏省社会发展面上基金资助项目(BE2020775)。

摘　　要：目的 探讨不同营养支持途径乙型肝炎病毒(HBV)感染相关肝硬化患者血清转化生长因子β1(TGF-β1)、高尔基体蛋白73(GP73)、可溶性白细胞2受体(SIL-2R)水平,并分析其治疗效果。方法 选取2021年2月-2024年1月江苏大学附属镇江三院收治的156例HBV感染相关肝硬化患者作为研究对象,采用随机数字表法分为三组[低热量肠内营养(HEN)组、常规热量肠外营养(PN)组和低热量肠外营养(HPN)组],各52例。三组均持续治疗5 d。比较三组胃肠道功能恢复时间、住院时间及营养支持费用,治疗前、治疗5 d后的肠道菌群分布、营养状况、TGF-β1、SIL-2R、GP73水平,治疗及住院期间的不良反应。结果 HEN组胃肠道功能恢复及住院的时间分别为(55.43±9.43) h、(9.54±1.32) d,均短于PN组、HPN组,HEN组营养支持费用为(413.54±59.54)元低于PN组、HPN组,HPN组低于PN组(P<0.05)。与治疗前比较,治疗5 d后,三组双歧杆菌、乳酸杆菌、肠杆菌均升高,且HEN组高于PN组、HPN组;三组酵母样真菌均降低,且HEN组低于PN组、HPN组(P<0.05)。治疗5 d后,三组血清白蛋白(ALB)、血红蛋白(Hb)、前白蛋白(PA)、转铁蛋白(TRF)、总蛋白(TP)水平均升高,且HEN组高于PN组、HPN组(P<0.05)。与治疗前比较,治疗5 d后,三组血清TGF-β1、SIL-2R、GP73水平均降低,且HEN组低于PN组、HPN组(P<0.05)。治疗及住院期间,HEN组、PN组及HPN组不良反应发生率分别为13.46%、15.38%、15.38%,差异无统计学意义(P=0.950)。结论 相较于肠外营养,HEN可显著改善HBV感染相关肝硬化患者营养状况及肠道菌群分布,改善患者血清TGF-β1、SIL-2R、GP73水平,进一步减轻患者炎症反应,并将患者胃肠道功能恢复及住院的时间缩短,且营养支持费用较少,安全性良好,而HPN营养支持费用较PN低。OBJECTIVE To investigate the effect of different nutritional support routes on serum transforming growth factorβ1(TGF-β1),golgi protein 73(GP73)and soluble leukocyte 2 receptor(SIL-2R)levels in patients with hepatitis B virus(HBV)infection-related liver cirrhosis,and to analyze their therapeutic effects.METHODS Totally 156 patients with HBV-infection related cirrhosis admitted to Jiangsu University Affiliated Zhenjiang Third Institute from Feb.2021 to Jan.2024 were selected as the study subjects and divided into the hypocaloric enteral nutrition(HEN),the parenteralnutrition(PN)and low-calorie parenteral nutrition(HPN)groups,using the ran-dom number table method,with 52 cases in each group.The three groups were all treated continuously for 5 days;the recovery time of gastrointestinal function,length of hospital stays and costs of nutritional support,and the distribution of intestinal flora,nutritional status,levels of TGF-β1,SIL-2R and GP73 before and after treatment,as well as adverse reactions during treatment and hospitalization among the three groups were compared.RESULTS The length of gastrointestinal function recovery and hospitalization in the HEN group were(55.43±9.43)h and(9.54±1.32)d,respectively,shorter than those in the PN and HPN groups.The cost of nutritional support in the HEN group was(413.54±59.54)yuan,which was the lowest,followed by HPN and PN group(P<0.05).Compared to pretreatment,Bifidobacterium,Lactobacillus and Enterobacterium increased in postt-reatment of the three groups,which in the HEN group were higher than those in the PN and HPN groups(P<O.O5);The levels of yeast-like fungi decreased in all three groups,which in the HEN group was lower than that in the PN and HPN groups(P<0.05).The levels of serum albumin(ALB),hemoglobin(Hb),prealbumin(PA),transferrin(TRF)and total protein(TP)raised in all the three groups,after the treatment for 5 days which in the HEN group were higher than those in the PN and HPN groups(P<0.05).Compared to pretreatment,levels of serum TGF-β1,SIL-2R and GP73

关 键 词：乙型肝炎病毒 肝硬化 营养支持 转化生长因子Β1 可溶性白细胞2受体 高尔基体蛋白73 营养状况 

分 类 号：R512.62[医药卫生—内科学]